• Dynamic anterior stabilization
• Glenohumeral instability
• Onlay

• Humans
• Male
• Female
• Shoulder Dislocation/surgery
• Shoulder Dislocation/diagnostic imaging
• Young Adult
• Recurrence
• Adult
• Arthroscopy/methods
• Prospective Studies
• Treatment Outcome
• Joint Instability/surgery
• Joint Instability/diagnostic imaging
• Follow-Up Studies
• Adolescent
• Tendons/surgery
• Tendons/transplantation
• Magnetic Resonance Imaging
• Shoulder Joint/surgery
• Shoulder Joint/diagnostic imaging

• Cairo University

• Biceps tenodesis
• Knotless
• Long head of biceps tendon
• Onlay tenodesis
• Suture anchor

• Tenodesis/methods
• Tenodesis/instrumentation
• Humans
• Suture Techniques
• Cadaver
• Biomechanical Phenomena
• Suture Anchors
• Tendons/surgery
• Male
• Female
• Middle Aged
• Aged

• Q202460 Wuxi Municipal Health Commission Youth Project
• Grant Number: YB202111 Duo-Innovative and Excellent Doctors Project of Wuxi Ninth People's Hospital
• Duo-Innovative and Excellent Doctors Project of Wuxi Ninth People’s Hospital

• anterolateral ligament reconstruction
• knee ligaments, ACL
• lateral extra-articular procedures
• ultrasound-guided surgery

• Elbow
• anatomic footprint repair
• distal biceps tendon
• intracortical button
• repair
• tear

• Humans
• Middle Aged
• Retrospective Studies
• Male
• Female
• Tendon Injuries/surgery
• Adult
• Range of Motion, Articular
• Supination
• Treatment Outcome
• Aged
• Elbow Joint/surgery
• Orthopedic Procedures/methods
• Follow-Up Studies

• PEEK suture anchor
• direct suture
• inlay suture
• rotator cuff repair
• tendon-to-bone healing

• Animals
• Rabbits
• Benzophenones
• Male
• Rotator Cuff Injuries/surgery
• Suture Anchors
• Polymers
• Ketones
• Suture Techniques
• Rotator Cuff/surgery
• Polyethylene Glycols
• Wound Healing
• Disease Models, Animal

• All-suture anchor
• Biceps tenodesis
• Biomechanics
• Proximal biceps brachii tendon
• Subpectoral
• Suprapectoral

• anchor
• inlay
• onlay
• screw
• shoulder
• subpectoral
• suprapectoral
• techniques

• Achilles tendon sleeve avulsion
• Cancellous bone
• Macrophage
• Rat model
• Tendon-to-bone healing
• Trans-calcaneal suture technique

• Animals
• Male
• Rats
• Achilles Tendon/surgery
• Biomechanical Phenomena
• Cancellous Bone/surgery
• Rats, Sprague-Dawley
• Suture Techniques
• Sutures
• Tendon Injuries/surgery
• Wound Healing

• 82002306 the National Science Foundation for Young Scientists of China
• 82130071 National Natural Science Foundation of China

• Humans
• Tenodesis/methods
• Anterior Cruciate Ligament Reconstruction/methods
• Anterior Cruciate Ligament Injuries/surgery
• Joint Instability/surgery
• Cadaver
• Knee Joint/surgery
• Range of Motion, Articular
• Biomechanical Phenomena

• Anatomic biceps repair
• Biceps
• Distal biceps rupture
• Suture anchor
• Tendon injuries

• medial patellofemoral ligament
• patellar instability
• pediatric
• physeal sparing
• reconstruction

• arthroscopic
• biceps tenodesis
• long head of the biceps tendon
• open

• Adult
• Arm/surgery
• Arthroscopy/methods
• Humans
• Middle Aged
• Muscle, Skeletal/surgery
• Rotator Cuff Injuries/surgery
• Tendons/surgery
• Tenodesis/methods

• biomechanics
• cadaver
• elbow, valgus
• reconstruction
• stability
• ulnar collateral ligament (UCL)

• Biceps tenodesis
• Biceps tenotomy
• Biceps-labral complex
• Long head of the biceps tendon
• Shoulder pathology
• Superior labrum anterior to posterior lesions

To biomechanically compare intramedullary (IM) versus extramedullary (EM) distal biceps button fixation under cyclic loading conditions, which is most representative of postoperative physiologic status.

This controlled laboratory study used 13 fresh-frozen matched paired cadaver elbows. One specimen from each pair was randomized to either IM (unicortical) or EM (bicortical) distal biceps button fixation via onlay technique. A servohydraulic actuator was used to cycle each specimen from full extension to 90° of flexion at 0.5 Hz for 3,000 cycles. All specimens were subsequently loaded to failure to simulate an acute postoperative load.

During cyclic loading, the mean change in force from cycle 5 to cycle 3000 was 2.1 ± 3.2 N for the IM group and 0.6 ± 4.2 N for the EM group (P = .19). The increase in tendon gap for the IM group was 1.02 mm and for the EM group was 1.83 mm (P = .37). During failure loading, the IM group had a mean failure load of 154.9 ± 44.5 N and the EM group a mean failure load of 191.1 ± 62.6 N (P = .16).

No significant differences exist between the IM and EM techniques in loss of force and tendon gap formation under cyclic loading or load to failure conditions. Thus, IM fixation may adequately facilitate optimal bone-tendon apposition, with less risk of iatrogenic injury to the posterior interosseous nerve that can be seen with bicortical extramedullary fixation.

The most common major complication following distal biceps repair is PIN palsy. IM fixation may be sufficient in facilitating optimal bone-tendon apposition and healing with onlay technique, while minimizing risk of iatrogenic PIN injury associated with EM fixation.

• mesenchymal stem cells
• bone-tendon enthesis
• orthopaedic tissue engineering
• interfacial tissue engineering
• transforming growth factor β
• differentiation

• Bone Morphogenetic Protein 4/metabolism
• Bone Morphogenetic Proteins/metabolism
• Cell Differentiation
• Cell Line
• Cell Lineage
• Chondrocytes/cytology
• Extracellular Matrix/metabolism
• Fibrocartilage
• Fluorescent Dyes/chemistry
• Growth Differentiation Factors/metabolism
• Humans
• Hydrogels/chemistry
• Intercellular Signaling Peptides and Proteins/metabolism
• Ligaments/injuries
• Mesenchymal Stem Cells/cytology
• Osteoblasts/metabolism
• Polymerase Chain Reaction
• Stem Cells/cytology
• Tendon Injuries/pathology
• Tendons
• Tissue Engineering/methods
• Tissue Scaffolds
• Transforming Growth Factor beta1/metabolism

• P41 EB023833 NIBIB NIH HHS

• Bone surface fixation
• Bone tunnel/trough fixation
• Bone–tendon healing
• Bone–tendon interface
• Partial patellectomy

• SLAP lesion
• arthroscopic SLAP repair
• biceps tenodesis
• biceps tenotomy
• post-op rehabilitation

Subpectoral biceps tenodesis can be performed with cortical fixation using different repair techniques. The goal of this technique is to obtain a strong and stable reduction of biceps tendon in an anatomic position.

The purpose of this study was to compare (1) displacement during cyclic loading, (2) ultimate load, (3) construct stiffness, and (4) failure mode of the biceps tenodesis fixation methods using onlay techniques with an all-suture anchor versus an intramedullary unicortical button. It was hypothesized that fixation with all-suture anchors using a Krackow stitch would exhibit biomechanical characteristics similar to those exhibited by fixation with unicortical buttons.

Controlled laboratory study.

Ten pairs of fresh-frozen cadaveric shoulders (N = 20) were dissected to the humerus, leaving the biceps tendon-muscle unit intact for testing. A standardized subpectoral biceps cortical (onlay) tenodesis was performed using either an all-suture anchor or a unicortical button. The biceps tendon was initially cycled from 5 to 70 N at a frequency of 1.5 Hz. The force on the tendon was then returned to 5 N, and the tendon was pulled until ultimate failure of the construct. Displacement during cyclic loading, ultimate failure load, stiffness, and failure modes were assessed.

Cyclic loading resulted in a mean displacement of 12.5 ± 2.5 mm for all-suture anchor fixation and 29.2 ± 9.4 mm for unicortical button fixation (P = .005). One all-suture anchor fixation and 2 unicortical button fixations failed during cyclic loading. The mean ultimate failure load was 170.4 ± 68.8 N for the all-suture anchor group and 125.4 ± 44.6 N for the unicortical button group (P = .074), with stiffness 59.3 ± 11.6 N/mm and 48.6 ± 6.8 N/mm (P = .091), respectively. For the unicortical button, failure occurred by suture tearing through tendon in 100% of the specimens. For the all-suture anchor, failure occurred by suture tearing through tendon in 56% and knot failure in 44% of the specimens.

The all-suture anchor fixation using a Krackow stitch for subpectoral biceps tenodesis provided ultimate load and stiffness similar to unicortical button fixation using a nonlocking whipstitch. The all-suture anchor fixation technique was shown to be superior in terms of displacement during cyclic loading when compared with the unicortical button fixation technique. However, the results of this study help to show that the fixation method used on the humeral side is less implicative of the overall construct strength than stitch location and technique, as the biceps tendon tissue and stitch configuration seem to be the limiting factor in subpectoral onlay tenodesis techniques.

All-suture anchors have a smaller diameter than traditional suture anchors, can be inserted through curved guides, and preserve humeral bone stock without compromising postoperative imaging. This study supports use of the all-suture anchor fixation technique for subpectoral biceps tenodesis, with high biomechanical fixation strength and low displacement, as an alternative to the subpectoral onlay biceps tenodesis technique.

• all-suture anchor
• onlay technique
• subpectoral biceps tenodesis
• unicortical button

• Lagomorpha
• animal experimentation
• bone density
• translational medical research

In recent years, understanding of the anatomy of the ulnar collateral ligament (UCL) has evolved, demonstrating that the insertional footprint of the UCL on the ulna is more elongated and distally tapered than previously described. Current UCL reconstruction configurations do not typically re-create this native anatomy, which may represent a potential area for improvement.

The purposes of this study were (1) to describe a novel anatomic UCL reconstruction technique designed to better replicate the native UCL anatomy and (2) to biomechanically compare this with the docking technique. The hypothesis was that the ultimate load to failure for the anatomic technique would not be inferior to the docking technique.

Controlled laboratory study.

A total of 16 fresh-frozen cadaveric upper extremities (8 matched pairs) were utilized. One elbow in each pair was randomized to receive UCL reconstruction via the docking technique or the novel anatomic UCL reconstruction technique with palmaris tendon autograft. Following reconstruction, biomechanical testing was performed by applying valgus rotational torque at a constant rate of 5 deg/s until ultimate mechanical failure of the construct occurred. Maximal torque (N·m), rotation stiffness (N·m/deg), and mode/location of failure were recorded for each specimen.

The mean ultimate load to failure for elbows in the docking technique group was 23.8 ± 6.1 N·m, as compared with 31.9 ± 8.4 N·m in the anatomic technique group (P = .045). Mean rotational stiffness was 1.9 ± 0.7 versus 2.3 ± 0.9 N·m/deg for the docking and anatomic groups, respectively (P = .338). The most common mode of failure was suture pullout from the graft, which occurred in all 8 (100%) docking technique specimens and 7 of 8 (88%) specimens that underwent the anatomic UCL reconstruction technique.

Ultimately, the anatomic UCL reconstruction technique demonstrated superior strength and resistance to valgus torque when compared with the docking technique, and this was comparable with that of the native UCL from prior studies. Increased initial strength may allow for earlier initiation of throwing postoperatively and potentially shorten return-to-play times.

Current UCL reconstruction techniques do not accurately reproduce the UCL insertional anatomy on the ulna. The novel anatomic technique described may result in more natural joint kinematics. This study demonstrated load-to-failure rates that are significantly higher than with the docking technique and consistent with the native ligament, as reported from previous studies. These findings may serve as a foundation for future clinical study and optimization of this technique.

• anatomic UCL reconstruction
• docking technique
• elbow
• medial ulnar collateral ligament
• modified Jobe technique
• novel

Significant proportion of rotator cuff tears (RCTs) in clinical field are of a kind of repairable tear wherein the degree of fatty infiltration is of Goutallier stage 1 or stage 2. Therefore, the animal model, showing similar fatty infiltration, seems preferable for researches. The purpose of this study is to find out the proper time frame in which there is Goutallier stage 1 or stage 2 fatty infiltration in the rabbit RCT model for the research of repairable RCT in humans.

Supraspinatus tendon tears were created in forty male New Zealand white rabbits at their right shoulder (n= 8 for each group), and a sham operation on the left shoulder. Rabbits were divided into five groups (2nd, 4th, 6th, 8th, and 12th weeks). Specimens were harvested from the central portion of the supraspinatus muscle for haematoxylin and eosin (H &E) staining, followed by histological and Goutallier grading evaluation. Results are expressed as mean ± standard deviation by Sigma Plot software (version 7.0).

At two weeks, mainly lipoblasts were observed around the muscle fibers, and at four weeks these lipoblasts were replaced by mature adipocytes with fatty infiltration amount (2.13 ± 0.35). The degree of muscle atrophy was (1.50 ± 0.53) at four weeks compared to sham group (0.88 ± 0.64) with significant difference (p < 0.05). The inflammatory process appeared as two phases. At two weeks, it was increased with grading value (1.88 ± 0.35). However, in the four-week group, it showed a sharp decrease (0.50 ± 0.53). At six weeks, inflammation reappeared to increase (1.13 ± 0.83). Then, a gradual decline appeared at eight weeks (0.88 ± 0.83) and at 12 weeks (0.50 ± 0.92).

At two and four weeks, both fat distribution in rabbit supraspinatus muscles and Goutallier grading scale mostly appeared as grade 2. Therefore, we can consider four weeks to be a suitable period for making a repairable RCT animal model for the human research, considering the early acute tissue reaction at 2 weeks after the tendon tears.

• Arthroscopic biceps tenodesis
• Biceps tenodesis
• Hidden biceps lesion
• Knotless suture anchor
• Suprapectoral biceps tenodesis
• Tension free biceps tenodesis