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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article discusses data from a matched cadaveric study that was conducted to compare the arthroscopic suprapectoral and open subpectoral techniques for biceps tenodesis. The data showed that the arthroscopic suprapectoral biceps tenodesis technique results in a more proximal tenodesis location, tends to overtension the biceps, and has a significantly reduced ultimate load to failure, compared with an open subpectoral biceps tenodesis technique.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EShoulder \u0026amp; Elbow Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures Clinical Trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EShoulder \u0026amp; Elbow Conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedic Procedures\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EOrthopaedics\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EStephen F. Brockmeier, MD, University of Virginia, Charlottesville, Virginia, USA, presented data from a matched cadaveric study that was conducted to compare the arthroscopic suprapectoral and open subpectoral techniques for biceps tenodesis. The data showed that the arthroscopic suprapectoral biceps tenodesis (ASPBT) technique results in a more proximal tenodesis location, tends to overtension the biceps, and has a significantly reduced ultimate load to failure, compared with an open subpectoral biceps tenodesis (OSPBT) technique.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETenodesis is an accepted treatment option in the management of pathology involving the long head of the biceps (LHB) tendon. However, although there is evidence that biceps tenodesis of the diseased tendon can improve patient symptoms, the optimal location for tenodesis remains controversial. The procedure can be performed open or arthroscopically, but there is a lack of evidence-based consensus available to guide surgeons\u0027 decision making.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EWith this in mind, Dr. Brockmeier and colleagues conducted a prospective study to directly compare the ASPBT using an interference screw implant and OSPBT for LHB tenodesis, particularly in terms of location, in vivo restoration of the LHB length-tension relationship, and the mechanical strength of the tenodesis.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe study included 18 matched cadaveric shoulder specimens randomly assigned to either ASPBT (n = 9) or OSPBT (n = 9). Surgery was performed by 2 sports fellowship\u2014trained surgeons using identical techniques. A preoperative metallic bead was sutured in place 1 cm distal to the biceps musculotendinous junction, and preoperative fluoroscopy was used to measure bead location. Postoperative fluoroscopy was also performed to determine the location of the tenodesis and the metallic bead, and preoperative and postoperative fluoroscopic images were compared to determine tensioning. Biomechanical testing was then performed on a material testing system machine; the surgical constructs were subjected to cyclic loading (100 cycles), followed by load-to-failure testing.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe mean tenodesis location in the ASPBT group was 4.68 cm distal to the top of the humerus, compared with 7.46 cm in the OSPBT group (p \u0026lt; .001). According to Dr. Brockmeier, these results were similar to those obtained in a separate clinical study.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe ASPBT technique tended to overtension the biceps significantly more than the OSPBT technique (2.15 cm vs .78 cm; p \u0026lt; .001). The average load to failure in the ASPBT group was 138.7 N, compared with 197.5 N in the OSPBT group (p \u0026lt; .001), and implant pullout was significantly more common in the ASPBT (n = 7 of 9) compared to the OSPBT (n = 1 of 9) group.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe results of this study appear to favor the open technique for biceps tenodesis, showing a risk of significant biceps overtensioning per contemporary arthroscopic techniques. Compared with implants in the open technique, currently available arthroscopic tenodesis implants may be susceptible to pullout failure at lower loads, and improved implants are likely necessary to produce a construct of equivalent mechanical strength.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/23\/16.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzowwp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}