The Experts below are selected from a list of 4812 Experts worldwide ranked by ideXlab platform
Heath B. Henninger - One of the best experts on this subject based on the ideXlab platform.
-
biomechanical evaluation of subpectoral biceps tenodesis dual suture anchor versus Interference Screw fixation
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference Screws have been shown to have superior biomechanical properties compared to suture anchors; although, only single anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare Interference Screw fixation with a suture anchor construct, using 2 anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an Interference Screw (8 � 12 mm; Arthrex) or 2 suture anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the suture anchor construct ‘‘softened’’ (decreased 9%, P <.001), whereas the Screw construct was unchanged (0.4%, P ¼ .078). Suture anchors had significantly higher ultimate failure strain than the Screws (P ¼ .003), but ultimate failure loads were similar between constructs: 280 � 95 N (Screw) vs 310 � 91 N (anchors) (P ¼ .438). Conclusion: The Interference Screw was significantly stiffer than the suture anchor construct. Ultimate failure loads were similar between constructs, unlike previous reports indicating Interference Screws had higher ultimate failure loads compared to suture anchors. Neither construct was superior with regards to stress; although, suture anchors could withstand greater elongation prior to failure. Level of evidence: Basic Science, Biomechanics, Cadaver Model. 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.
-
Biomechanical evaluation of subpectoral biceps tenodesis: dual suture anchor versus Interference Screw fixation
Journal of shoulder and elbow surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference Screws have been shown to have superior biomechanical properties compared to suture anchors; although, only single anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare Interference Screw fixation with a suture anchor construct, using 2 anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an Interference Screw (8 � 12 mm; Arthrex) or 2 suture anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the suture anchor construct ‘‘softened’’ (decreased 9%, P
Robert Z. Tashjian - One of the best experts on this subject based on the ideXlab platform.
-
biomechanical evaluation of subpectoral biceps tenodesis dual suture anchor versus Interference Screw fixation
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference Screws have been shown to have superior biomechanical properties compared to suture anchors; although, only single anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare Interference Screw fixation with a suture anchor construct, using 2 anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an Interference Screw (8 � 12 mm; Arthrex) or 2 suture anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the suture anchor construct ‘‘softened’’ (decreased 9%, P <.001), whereas the Screw construct was unchanged (0.4%, P ¼ .078). Suture anchors had significantly higher ultimate failure strain than the Screws (P ¼ .003), but ultimate failure loads were similar between constructs: 280 � 95 N (Screw) vs 310 � 91 N (anchors) (P ¼ .438). Conclusion: The Interference Screw was significantly stiffer than the suture anchor construct. Ultimate failure loads were similar between constructs, unlike previous reports indicating Interference Screws had higher ultimate failure loads compared to suture anchors. Neither construct was superior with regards to stress; although, suture anchors could withstand greater elongation prior to failure. Level of evidence: Basic Science, Biomechanics, Cadaver Model. 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.
-
Biomechanical evaluation of subpectoral biceps tenodesis: dual suture anchor versus Interference Screw fixation
Journal of shoulder and elbow surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference Screws have been shown to have superior biomechanical properties compared to suture anchors; although, only single anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare Interference Screw fixation with a suture anchor construct, using 2 anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an Interference Screw (8 � 12 mm; Arthrex) or 2 suture anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the suture anchor construct ‘‘softened’’ (decreased 9%, P
Augustus D. Mazzocca - One of the best experts on this subject based on the ideXlab platform.
-
effect of Interference Screw depth on fixation strength in biceps tenodesis
Arthroscopy, 2014Co-Authors: Michael J Salata, James R Bailey, Rebecca Bell, Rachel M Frank, Kevin C Mcgill, Emery C Lin, James S Kercher, Vincent M Wang, Matthew T Provencher, Augustus D. MazzoccaAbstract:Purpose The purpose of this study was to assess the biomechanical performance of the long head of the biceps tenodesis with an Interference Screw with respect to Screw depth. Methods Twenty-one human cadaveric shoulders were randomized into 3 treatment groups (7 each): Interference Screw placed flush to the humeral cortex, 50% proud, or fully recessed. Bone density was determined, and subpectoral biceps tenodesis was performed with 8 × 12 mm Bio-Tenodesis Screws (Arthrex, Naples, FL). Each construct was cyclically loaded from 5 to 70 N for 500 cycles at 1 Hz and then pulled to failure at 1 mm/s. Relative actuator displacement was calculated from cyclic testing. Maximum load, elongation, linear stiffness, and failure mode were recorded from pull-to-failure testing. Because of numerous failures during cyclic testing, the final load data from the fully recessed group were not statistically analyzed. The remaining groups were compared by use of a 2-tailed, Student unpaired t test and χ 2 analysis. Results There was no significant difference in displacement among groups during cyclic testing. Five specimens in the recessed group failed during cyclic testing, whereas 2 specimens and 0 specimens failed in the proud and flush groups, respectively. The maximum loads sustained were 281.6 ± 77.8 N, 184.5 ± 56.3 N, and 209.1 ± 57.0 N for the flush group, 50% proud group, and recessed group (in those specimens surviving cyclical loading), respectively. Conclusions Placement of a Bio-Tenodesis Screw flush to the humeral cortex is preferred for maximum fixation strength in subpectoral biceps tenodesis. A Screw placed to 50% depth may be effective in the laboratory setting, but recessed placement is more variable and requires additional fixation. The fully recessed group resulted in 5 of 7 failures during cyclical loading, with no specimens failing in the flush group. Clinical Relevance This study shows the importance of determining the optimal depth of Interference Screw placement during biceps tenodesis to obtain optimal biomechanical performance and reduce the risk of fixation failure.
-
Biomechanical performance of subpectoral biceps tenodesis: a comparison of Interference Screw fixation, cortical button fixation, and Interference Screw diameter.
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Paul M. Sethi, Arun Rajaram, Knut Beitzel, Thomas R. Hackett, David M. Chowaniec, Augustus D. MazzoccaAbstract:Background Subpectoral biceps tenodesis with Interference Screw fixation allows reproducible positioning of the tendon to help maintain the length–tension relationship. The aim of our study was to evaluate the role of cortical button fixation in isolation or as an augment to Interference Screw fixation and to determine if the diameter of the Interference Screw affected fixation strength. Materials and methods Thirty-two cadaveric shoulders were dissected and randomized to 1 of 4 groups: (1) 7-mm Interference Screw and cortical button, (2) cortical button alone, (3) 7-mm Interference Screw, or (4) 8-mm Interference Screw. Testing was performed on a materials testing system with a 100-N load cycled at 1 Hz for 5000 cycles, followed by an axial load to failure test. Cyclic displacement, ultimate load to failure, and site of failure were recorded for each specimen. Results The mean ultimate failure loads were 7-mm Interference Screw with cortical button augmentation, 237.8 ± 120.4 N; cortical button alone, 99.4 ± 16.9 N; 7-mm Interference Screw, 275.5 ± 56 N; 8-mm Interference Screw, 277.1 ± 42.1 N. All specimens failed through tendon failure at the Screw–tendon–bone interface. Conclusions The biomechanical performance of subpectoral biceps tenodesis with Interference Screw fixation was not improved with cortical button augmentation. In addition, cortical button fixation alone yielded a significantly lower ultimate load to failure compared with Interference Screws. Finally, the biomechanical performance of smaller-diameter Interference Screws with matching bone tunnels was not affected by Interference Screw diameter.
-
biomechanical evaluation of distal biceps reconstruction with cortical button and Interference Screw fixation
Journal of Shoulder and Elbow Surgery, 2010Co-Authors: Paul M. Sethi, Elifho Obopilwe, Lina Rincon, Seth R Miller, Augustus D. MazzoccaAbstract:Hypothesis Tension slide repair maintains the strength of the standard cortical button repair but reduces gap formation at the repair. Distal biceps tendon repair with a suspensory cortical button has yielded the strongest published repair, despite observed gap formation and tendon pistoning. The tension slide technique (TST) was described to reduce gap formation while maintaining the strength of cortical button repair. This study evaluates the biomechanics of the TST compared with previously described EndoButton (Smith & Nephew, Memphis, TN) repair and the TST with and without an Interference Screw. Materials and methods The study used 20 matched specimens: 5 had a standard cortical button repair, and 5 had biceps repair with the TST. An additional 10 specimens underwent a TST, 5 with an Interference Screw and 5 without. All were cyclically loaded for 3600 cycles. Gap formation and load to failure were measured. Results The mean (SD) load to failure for standard technique was at 389 (148) N vs 432 (66) N for the TST ( P = .28). The mean (SD) gap formation was 2.79 (1.43) mm with the standard repair and 1.26 (0.61) mm with the TST ( P = .03). The mean (SD) load to failure with TST repair was 436 (103) N without the Interference Screw and 439 (94) N ( P = 0.48) with the Screw. The mean gap formation was 1.63 (1.09) mm without the Screw and 1.45 (0.67) mm with the Screw ( P = .38.) Conclusion This TST maintains the strength of the standard cortical button repair, but significantly reduces gap formation and motion at the repair site. Level of evidence Basic science study.
-
a combined technique for distal biceps repair using a soft tissue button and biotenodesis Interference Screw
American Journal of Sports Medicine, 2009Co-Authors: Andrew D Heinzelmann, Felix H Savoie, Randall J Ramsey, Larry D Field, Augustus D. MazzoccaAbstract:BackgroundThere are many techniques described to repair acute distal biceps tendon ruptures. The authors’ objective is to report the results of a single-incision technique using a combination of a soft tissue button and biotenodesis Interference Screw with accelerated rehabilitation.HypothesisDual fixation of a distal biceps rupture will allow for early return to function.Study DesignCase series; Level of evidence, 4.MethodsFrom February 2004 to July 2007, 41 elbows in 40 patients had repair of an acute distal biceps tendon rupture (<6 weeks) through an anterior incision using a soft tissue button and Interference Screw combined technique. The patients were evaluated pre- and postoperatively with a physical examination, radiographs, and the Andrews-Carson elbow score. Nine patients were unavailable for follow-up. The remaining 31 patients (32 elbows) were contacted for a telephone interview at an average of 24 months postoperatively.ResultsThe preoperative Andrews-Carson score averaged 168 and the postope...
-
Interference Screw with Cortical button for distal biceps repair.
Sports medicine and arthroscopy review, 2008Co-Authors: Clifford G. Rios, Augustus D. MazzoccaAbstract:The management of distal biceps tendon ruptures has been the source of considerable research over the last decade. Many of the techniques used to secure tendon to bone have been applied to the distal biceps tendon. These include suture anchors, Cortical button, and more recently Interference Screw fixation. The current account describes a technique that repairs the distal biceps with combined Interference Screw and Cortical button fixation through a single incision, which permits immediate active postoperative motion for early return to activity and a decrease in postoperative stiffness or heterotopic ossification. The presented technique offers the surgeon many new options in treatment of these injuries and emphasizes biologic, anatomic, and biomechanical principles of tendon healing.
Christopher S Ahmad - One of the best experts on this subject based on the ideXlab platform.
-
distal biceps tendon repair a cadaveric analysis of suture anchor and Interference Screw restoration of the anatomic footprint
American Journal of Sports Medicine, 2009Co-Authors: Charles M Jobin, Matthew A Kippe, Thomas R Gardner, William N Levine, Christopher S AhmadAbstract:BackgroundDistal biceps tendon repair with Interference Screw or double suture-anchor fixation are 2 successful techniques performed with either 1- or 2-incision approaches. No study has examined the accuracy and quality of the repaired tendon footprint with these devices and approaches.HypothesisA 2-incision approach will allow a more anatomic repair of the distal biceps footprint compared with a 1-incision anterior approach. Fixation technique will affect insertional footprint location and footprint contact area.Study DesignControlled laboratory study.MethodsAfter randomization, 36 distal biceps repairs were performed on human cadaveric upper extremity specimens, with 1- or 2-incision approaches and with fixation devices of either two 5.5-mm suture anchors or an 8-mm Interference Screw. Native and repaired footprint areas and centroid location were calculated with a 3-dimensional digitizer.ResultsInterference Screw repair had the smallest footprint area (135 mm2) compared with suture anchor repair (197 ...
Jon J P Warner - One of the best experts on this subject based on the ideXlab platform.
-
Interference Screw vs suture anchor fixation for open subpectoral biceps tenodesis does it matter
BMC Musculoskeletal Disorders, 2008Co-Authors: Peter J. Millett, Brett Sanders, Reuben Gobezie, Sepp Braun, Jon J P WarnerAbstract:Background Bioabsorbable Interference Screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results.