AOSSM/AANA Specialty Day 2020-Handout - Radiostereometric Analysis of Biceps Tenodesis

Handout - Radiostereometric Analysis of Biceps Tenodesis_ A Comparison of Techniques

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This prospective cohort study evaluated the stability of biceps tenodesis (BT) constructs using radiostereometric analysis (RSA) by comparing arthroscopic suprapectoral (ASPBT) and open subpectoral (OSPBT) techniques with two fixation methods: interference screw (IS) made of Polyetheretherketone (PEEK) and all-suture suture anchor (ASSA). A tantalum bead was sutured to the biceps tendon as a radiographic marker to measure postoperative migration at one and 12 weeks.<br /><br />A total of 119 patients (average age 52 years, BMI 30.8, 29% female) were analyzed. The study showed no significant difference in distal tendon migration between ASPBT and OSPBT using interference screws. BT fixed with a single all-suture anchor demonstrated significantly greater distal migration compared to interference screw fixation, indicating less construct stability. BT with double all-suture anchors showed less migration than single ASSA and was comparable to interference screw fixation, with no significant difference between double ASSA and IS groups.<br /><br />The findings suggest that both open and arthroscopic biceps tenodesis techniques using interference screw fixation provide reliable stability. Single all-suture anchor fixation is inferior due to increased tendon migration; however, using two all-suture anchors enhances construct stability comparable to interference screws. The authors therefore recommend employing double all-suture anchors for both open and arthroscopic biceps tenodesis to optimize postoperative tendon fixation.<br /><br />This study provides the first in vivo quantification of biceps tenodesis construct behavior during the postoperative period, using precise RSA to measure micromotion and fixation integrity. It informs surgical practice by highlighting the importance of fixation method and anchor number in maintaining tendon position and potentially improving clinical outcomes.

Keywords

biceps tenodesis

radiostereometric analysis

arthroscopic suprapectoral technique

open subpectoral technique

interference screw fixation

all-suture suture anchor

tendon migration

construct stability

double all-suture anchors

postoperative tendon fixation