Hasan SA. J Shoulder Elbow Surg. 2011. doi:10.1016/j.jse.2011.04.027
Anatomic repair of the biceps tendon to the original insertion site can be improved more effectively through a 2-incision technique than a 1-incision technique, according to researchers in Maryland.
To compare the 2-incision technique with the 1-incision technique, the researchers randomly assigned 20 cadaveric arms to one of two groups: a 1-incision group or a 2-incision group. The 1-incision group had their bicipital tuberosity exposed through a single anterior incision, while the 2-incision group underwent a posterolateral approach. The axis for creating a virtual bone tunnel was marked through a guide pin placed into the tuberosity, and radius was harvested with an intact biceps insertion.
A 3D computerized digitizer measured the length, width and area of the insertion footprint for each tendon, and a virtual bone tunnel 7.5 mm in diameter was centered over a guidewire-created drill hole. Researchers then determined the percentage of the virtual tunnel within the original footprint.
According to the study results, the team found 73.4% of the virtual tunnel was within the original tendon footprint when the posterolateral approach was used, as opposed to 9.7% for the anterior approach. The authors noted a statistically significant difference between medial values of covered footprint in a comparison of the two types of repair.
“Prospective clinical studies directly comparing the two techniques with regard to the strength of supination after repair may be helpful,” the authors wrote.