TY  - BOOK
AU  - Carpenter, Shannon R
AU  - Murthi, Anand M
AU  - Parks, Brent G
AU  - Ramirez, Miguel A
TI  - Lacertus Fibrosus Versus Achilles Allograft Reconstruction for Distal Biceps Tears: A Biomechanical Study
SN  - 0363-5465
PY  - 2017///
KW  - *Achilles Tendon/su [Surgery]
KW  - *Muscle, Skeletal/su [Surgery]
KW  - *Orthopedic Procedures/mt [Methods]
KW  - *Reconstructive Surgical Procedures/mt [Methods]
KW  - Adult
KW  - Aged
KW  - Aged, 80 and over
KW  - Allografts/su [Surgery]
KW  - Arm/su [Surgery]
KW  - Biomechanical Phenomena
KW  - Cadaver
KW  - Elbow Joint/su [Surgery]
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Radius/su [Surgery]
KW  - Tendon Injuries/su [Surgery]
KW  - Transplantation, Homologous
KW  - Ulna/su [Surgery]
KW  - MedStar Union Memorial Hospital
KW  - Department of Orthopaedic Surgery
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND: The bicipital aponeurosis, or lacertus fibrosus, can potentially be used as a reconstruction graft in chronic distal biceps tendon tears; CLINICAL RELEVANCE: Use of the lacertus fibrosus may be a potential alternative to Achilles tendon allograft reconstruction of chronic distal biceps tears when primary repair is not possible; CONCLUSION: The mean stiffness and load-to-failure values were not significantly different between a lacertus fibrosus construct and Achilles tendon allograft; METHODS: Ten fresh-frozen matched cadaveric pairs of elbows were used. Three centimeters of the distal biceps tendon was resected. Specimens were randomized to the lacertus fibrosus or Achilles tendon group. In one group, the lacertus fibrosus was released from its distal attachment and then tubularized and repaired intraosseously to the radius. In the other group, an Achilles tendon graft was sutured to the biceps muscle and repaired to the ulna. The prepared radii were rigidly mounted at a 45degree angle on a load frame. The proximal biceps muscle was secured in a custom-fabricated cryogenic grip. Displacement was measured using a differential variable reluctance transducer mounted at the radius-soft tissue junction and in the muscle- or muscle allograft-tissue junction proximal to the repair. Specimens were loaded at 20 mm/min until failure, defined as a 3-mm displacement at the radius-soft tissue junction; PURPOSE: To evaluate construct stiffness, load to failure, and failure mechanism with lacertus fibrosus versus Achilles allograft for distal biceps tendon reconstruction; RESULTS: No significant difference was found in mean load to failure between the lacertus fibrosus and Achilles tendon group (mean +/- SD, 20.2 +/- 5.5 N vs 16.89 +/- 4.54 N; P = .18). Stiffness also did not differ significantly between the lacertus fibrosus and Achilles tendon group (12.3 +/- 7.1 kPa vs 10.5 +/- 5.7 kPa; P = .34). The primary mode of failure in the lacertus fibrosus group was suture pullout from the tissue at the musculotendinous junction (7 of 10). In the Achilles group, failures were observed at the muscle-allograft interface (3) and the allograft-bone (radial tuberosity) interface (3), and 3 suture failures were observed. The button fixation did not fail in any specimens; STUDY DESIGN: Controlled laboratory study
UR  - https://dx.doi.org/10.1177/0363546517727511
ER  -