CC2021: Optimizing Fixation for Distal Biceps Tendon Repair: A Systematic Review and Meta-Regression of Cadaveric Biomechanical Testing (September 2021)-CC2021: Optimizing Fixation for Distal Biceps Tendon Repair: A Systematic Review and Meta-Regression of Cadaveric Biomechanical Testing (September 2021)

CC2021: Optimizing Fixation for Distal Biceps Tendon Repair: A Systematic Review and Meta-Regression of Cadaveric Biomechanical Testing (September 2021)

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A systematic review and meta-regression was conducted to assess the biomechanical performance of different fixation techniques for distal biceps tendon (DBT) repairs. The study analyzed data from 14 biomechanical studies involving cadaveric specimens. The results showed that cortical button fixation had the highest adjusted failure load (AFL) compared to other fixation types such as suture anchors, bone tunnels, and interference screws. However, when comparing implant types, cortical button fixation was significantly stronger than suture anchor repair, but not significantly stronger than constructs using interference screws or bone tunnels. The presence of a locking stitch was associated with increased AFL, while using more sutures in the construct was associated with lower odds of type 2 failure. Constructs using cortical buttons had a lower risk of type 2 failure compared to those without implants or using interference screws alone. The addition of an interference screw to cortical button fixation did not provide additional strength. Overall, the study concluded that cortical button fixation is associated with greater construct strength and lower risk of type 2 failure compared to other fixation techniques. However, the clinical implications of these findings need to be further investigated.

Keywords

systematic review

biomechanical performance

fixation techniques

distal biceps tendon repairs

cortical button fixation

suture anchors

bone tunnels

interference screws

adjusted failure load

construct strength