A Radiostereometric Analysis of Tendon Migration After Arthroscopic and Mini-Open Biceps Tenodesis: Interference Screw Versus Single Suture Anchor Fixation.

Autor:	Forsythe B; Midwest Orthopaedics at Rush, Chicago, Illinois, USA., Patel HH; Midwest Orthopaedics at Rush, Chicago, Illinois, USA., Berlinberg EJ; Midwest Orthopaedics at Rush, Chicago, Illinois, USA., Forlenza EM; Rush University Medical Center, Chicago, Illinois, USA., Okoroha KR; Mayo Clinic Orthopedics and Sports Medicine, Minneapolis, Minnesota, USA., Williams BT; University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., Yanke AB; Midwest Orthopaedics at Rush, Chicago, Illinois, USA., Cole BJ; Midwest Orthopaedics at Rush, Chicago, Illinois, USA., Verma NN; Midwest Orthopaedics at Rush, Chicago, Illinois, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2023 Sep; Vol. 51 (11), pp. 2869-2880. Date of Electronic Publication: 2023 Aug 07.
DOI:	10.1177/03635465231187030
Abstrakt:	Background: Studies suggest that similar clinical results are achieved via arthroscopic and open biceps tenodesis (BT) techniques. Purpose: To quantify the postoperative migration of the BT construct between arthroscopic suprapectoral BT (ASPBT) and open subpectoral BT (OSPBT) techniques via interference screw (IS) or single-suture suture anchor (SSSA) fixation using radiostereometric analysis. Study Design: Cohort study; Level of evidence, 2. Methods: Distal migration of the biceps tendon after OSPBT with a polyetheretherketone IS, OSPBT with 1 SSSA, ASPBT with polyetheretherketone IS, and ASPBT with 2 SSSAs was measured prospectively. Patients with symptomatic biceps tendinopathy and preoperative patient-reported outcome measures (PROMs) including Constant-Murley subjective, Single Assessment Numeric Evaluation, or Patient-Reported Outcomes Measurement Information System-Upper Extremity scores were included. A tantalum bead was sutured on the proximal end of the long head of the biceps tendon before fixation of tendon tissue. Anteroposterior radiographs were performed immediately postoperatively, at 1 week, and at 3 months. Bead migration was measured, and preoperative PROMs were compared with those at latest follow-up. Results: Of 115 patients, 94 (82%) were available for final follow-up. IS fixation yielded the least tendon migration with no difference between the open and arthroscopic approaches (4.31 vs 5.04 mm; P = .70). Fixation with 1 suture anchor demonstrated significantly greater migration than that achieved with an IS at both 1 week (6.47 vs 0.1 mm, 6.47 vs 1.75 mm, P < .001;) and 3 months (14.76 vs 4.31 mm, 14.76 vs 5.04 mm, P < .001) postoperatively. Two-suture anchor fixation yielded significantly greater migration than IS fixation at 1 week (7.02 vs 0.1 mm, P < .001; 7.02 vs 1.75 mm, P = .003) but not 3 months postoperatively (8.06 vs 4.31 mm, P = .10; 8.06 vs 5.04 mm, P = .07). Four patients with suture anchor fixation (3 patients in the OSPBT 1 SSSA group, 9.4%, and 1 patient in the ASPBT 2 SSSAs group, 3.8%) developed a Popeye deformity, whereas no Popeye deformities occurred in the IS groups. Mean 3-month bead migration in patients with and without a Popeye deformity was 60.8 and 11.2 mm, respectively ( P < .0001). PROMs did not differ among groups at final follow-up. Conclusion: Interference screw fixation yielded the least tendon migration whether achieved arthroscopically or open. The available data indicated that fixation with 1 SSSA but not 2 SSSAs resulted in significantly greater migration than that achieved with an IS. Despite variations in tendon migration, PROMs were similar among all groups. When SSSAs are used, tendon migration may be minimized by using ≥2 anchors.
Databáze:	MEDLINE
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