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Interference screw technique yielded more anatomic failures in arthroscopic biceps tenodesis
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Despite no significant differences in functional outcomes, results showed patients who underwent arthroscopic biceps tenodesis with an interference screw technique experienced more anatomic failures than patients with suture anchor fixation.
Researchers randomized patients who underwent arthroscopic rotator cuff repair for superior labrum-biceps complex lesions to either interference screw (IS) (33 patients) or suture anchor (SA) fixation (34 patients). At least 2 years postoperatively, they evaluated function using the VAS for pain, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, Constant score, Korean Shoulder Score and long head of the biceps score. Researchers also estimate the anatomic status of tenodesis with MRI or ultrasonography.
Results showed a significant improvement in preoperative and postoperative functional scores with no significant differences between the groups, including the long head of the biceps score. Researchers noted seven tenodesis failures in the IS group and two failures in the SA group.
Factors significantly associated with the anatomic failure of biceps tenodesis included IS fixation and a higher work level, according to results of a multivariate analysis using logistic regression. Researchers noted a statistical difference in the long head of the biceps score and the degree of Popeye deformity by the patient and examiner between patients with a tenodesis failure and patients with intact tenodesis. – by Casey Tingle
Disclosure: The researchers report they received funding from Smith & Nephew Endoscopy.
Perspective
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M. Michael Khair, MD
Park and co-authors studied interference screw (IS) fixation vs. suture anchor (SA) fixation for arthroscopic biceps tenodesis. They showed that while at 2 years postop there was no difference in patient-reported outcomes, there were more anatomic failures in the IS group. In multivariate analysis, IS fixation and physically demanding work level both predicted failure. Interestingly, however, there were a higher number of demanding work patients in the SA group (15:34) than the IS group (8:33). This further suggests that SA fixation may be superior to IS fixation using this technique. Potential additional benefits to SA fixation include smaller drill holes and decreased risk of stress riser and fracture. Although, ultimately, surgeon preference prevails, these results lend support to SA fixation. It would be interesting to see this same study carried out in an open, subpectoral tenodesis cohort to see if the findings are similar.
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