Biceps Tenodesis With Interference Screw Fixation: A Biomechanical Comparison of Screw Length and Diameter

Numerous surgical procedures have been suggested to address pathology associated with the long head of the biceps tendon. Techniques range from simple debridement to tenotomy or tenodesis. Currently, there is no consensus as to whether tenotomy or tenodesis is most appropriate, and biomechanical and clinical studies have shown both procedures to be effective. Tenodesis might be preferred over tenotomy for several reasons, including improved cosmetic appearance, maintenance of elbow flexion and supination strength, and maintenance of the biceps muscle length-tension relation, as described by Mazzocca et al.

Although several biomechanical studies have been published on different biceps tenodesis fixation techniques, there are no studies that specifically evaluate the fixation stability of biceps tenodesis either proximally or distally in relation to screw diameter or length. The purpose of this study was to analyze the biomechanical behavior of the bone-tendon-screw complex of polyetheretherketone (PEEK) interference screws of different size and length used for biceps tenodesis at both proximal and distal fixation sites. Our hypothesis was that longer screws in the proximal location may provide improved biomechanical performance.