Distal biceps tendon repair via new knotless endobutton fixation: A biomechanical study
Résumé
Background: Distal biceps tendon (DBT) repair using endobutton fixation has shown the best biomechanical results in terms of pullout strength. Sethi's enhanced tension adjustable endobutton technique known as the « tension slide technique » (TST) decreases the gap between bone tunnel and graft. Here we compared the TST to a new knotless endobutton fixation technique without a post-fixation screw. Our new approach is as effective as the TST in terms of pullout strength and gapping after early mobilization. Methods: A biomechanical cadaveric study with 8 specimens was performed (16 arms). Right and left arms were paired and each arm was placed in either the knotless or the TST group. With the radius held in place, the DBT was loaded at 100 N for 500 cycles and the load was then increased until failure. Gapping after loading cycles and maximum load to failure were recorded and compared. Results: Median bone-tendon gapping was 5.77 mm [interquartile range (IQR) 4.84-9.11] for TST and 4.72 mm [IQR 1.77-6.16] for the knotless fixation (p = 0.047). Median load to failure was 257.87 N [IQR 222.07-325.35] in the TST group and 407.78 N [IQR 358.54-485.20] in the knotless group (p = 0.047).
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