HYPOTHESIS: The purpose of this study was to accurately map the insertional footprint of the distal biceps tendon and to test our hypothesis that a superior anatomic repair can be achieved by a 2-incision technique when compared with a 1-incision technique. METHODS: We randomly assigned 20 cadaveric arms to 1 of 2 groups: 1 incision (group I) or 2 incision (group II). The bicipital tuberosity was exposed through either a single anterior incision (group I) or a posterolateral approach (group II). A guide pin was placed into the tuberosity to mark the axis for creating a virtual bone tunnel. Each radius was harvested with the biceps insertion intact. The length, width, and area of the insertion footprint for each tendon were determined with a 3-dimensional computerized digitizer. A 7.5 mm-diameter virtual bone tunnel was centered over the drill hole created by the guidewire. The percentage of the virtual tunnel within the original footprint was determined. RESULTS: The percentage of the virtual tunnel (repair site) within the original tendon footprint was 73.4% for the posterolateral approach and only 9.7% for the anterior approach. There was a statistically significant difference (P ≤ .001) in the median values of footprint covered when the 2 types of repair were compared. DISCUSSION AND CONCLUSION: The 2-incision technique results in a significantly improved anatomic repair of the biceps tendon to the original insertion site. Prospective clinical studies directly comparing the 2 techniques with regard to the strength of supination after repair may be helpful.
RCT Entities:
HYPOTHESIS: The purpose of this study was to accurately map the insertional footprint of the distal biceps tendon and to test our hypothesis that a superior anatomic repair can be achieved by a 2-incision technique when compared with a 1-incision technique. METHODS: We randomly assigned 20 cadaveric arms to 1 of 2 groups: 1 incision (group I) or 2 incision (group II). The bicipital tuberosity was exposed through either a single anterior incision (group I) or a posterolateral approach (group II). A guide pin was placed into the tuberosity to mark the axis for creating a virtual bone tunnel. Each radius was harvested with the biceps insertion intact. The length, width, and area of the insertion footprint for each tendon were determined with a 3-dimensional computerized digitizer. A 7.5 mm-diameter virtual bone tunnel was centered over the drill hole created by the guidewire. The percentage of the virtual tunnel within the original footprint was determined. RESULTS: The percentage of the virtual tunnel (repair site) within the original tendon footprint was 73.4% for the posterolateral approach and only 9.7% for the anterior approach. There was a statistically significant difference (P ≤ .001) in the median values of footprint covered when the 2 types of repair were compared. DISCUSSION AND CONCLUSION: The 2-incision technique results in a significantly improved anatomic repair of the biceps tendon to the original insertion site. Prospective clinical studies directly comparing the 2 techniques with regard to the strength of supination after repair may be helpful.
Authors: Ruby Grewal; George S Athwal; Joy C MacDermid; Kenneth J Faber; Darren S Drosdowech; Graham J W King Journal: JBJS Essent Surg Tech Date: 2012-11-28