Single suture anchors may increase tendon displacement after biceps tenodesis

Forsythe B, et al. Paper 51. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.

Forsythe B, et al. Paper 51. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.

WASHINGTON — Results presented here showed use of single all-suture suture anchors may increase tendon migration after a biceps tenodesis compared with interference screws.

“You should think twice about using a single all-suture suture anchor, as there was the most migration with that,” Brian Forsythe, MD, FAAOS, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting.

He added, “If you're going to do a subpectoral approach, consider the interference screw. But you can also do it arthroscopically. Use two all-suture suture anchors or one that is double loaded.”

Forsythe and colleagues assessed radiographic imaging immediately postoperatively, as well as at 1 week and 3 months postoperatively, and patient-reported outcome measures among 120 patients who underwent open subpectoral biceps tenodesis with a polyetheretherketone (PEEK) interference screw (n=30), open subpectoral biceps tenodesis with one single-suture suture anchor (n=30), arthroscopic suprapectoral biceps tenodesis with PEEK interference screw (n=30) or arthroscopic suprapectoral biceps tenodesis with two single-suture suture anchors (n=30). In addition, researchers utilized a tantalum bead to compare tendon migration between the open and arthroscopic techniques, measuring and marking the movement of the bead from the top of the humeral head at each time interval.

Results showed single all-suture suture anchors had an association with greater tendon migration compared with interference screws. Forsythe said that a single all-suture suture anchor had about a 15-mm tendon displacement compared to 4 mm to 5 mm of displacement with interference screws. Despite the differences in tendon migration, Forsythe noted no clinically significant differences in patient-reported outcome measures between the four groups.

“We found that patients with higher BMI, so presumably more de-conditioned and heavier patients, were more likely to achieve [minimally clinically important difference] MCID and [substantial clinical benefit] SCB,” Forsythe said. “Patients with less biceps tendon migration were also more likely to reach [clinically significant outcomes] CSOs, specifically MCID and [patient-acceptable symptomatic state] PASS.”