Does biceps tenodesis screw with forked eyelet decrease the risk of Popeye deformity when compared to traditional closed eyelet screws?

Abstract

Objective: While many biomechanical studies have compared various biotenodesis materials for biceps tenodesis, there is a lack of research comparing different types of interference screws. This study aimed to compare the impact of a polyether ether ketone (PEEK) forked eyelet tenodesis screw with the traditional PEEK closed eyelet whipstitching technique. The focus was on evaluating the occur- rence of Popeye deformity, which is an objective predictor of a successful arthroscopic suprapectoral long head of biceps tenodesis. Methods: A retrospective analysis was conducted on patients who underwent arthroscopic rotator cuff repair and biceps tenodesis per- formed by a single surgeon between January 2010 and 2020 at a single center. The follow-up period was at least 1 year. Exclusion criteria included previous shoulder surgery and osteoarthritis. Patients were divided into 2 groups based on the type of tenodesis anchor used: forked eyelet tenodesis screw versus closed eyelet tenodesis screw. The occurrence of Popeye deformity was compared between the 2 groups. Results: A total of 82 patients who underwent arthroscopic rotator cuff repair and biceps tenodesis were evaluated, with a mean follow-up of 24.5 ± 4 months. The patients operated on using forked eyelet tenodesis screw were labeled as Group I (n = 72) and those with traditional PEEK closed eyelet screw as Group II (n= 10). There were no significant differences between the groups in terms of age (Group I: 59.4 ± 5, Group II: 58.4 ± 4, P = .896), gender (both groups predominantly male, P = .886), and body mass index (Group I: 26.7 ± 2, Group II: 27 ± 3; P = .896). The overall rate of popeye deformity in all patients was 8% (n= 7). No significant difference in popeye deformity occurrence was observed between the 2 groups (Group I: 6/72 (8.3%), Group II: 1/10 (10%); P = .998). Conclusion: The incidence of Popeye deformity after arthroscopic biceps tenodesis in patients undergoing concomitant rotator cuff repair is low. The choice of fixation anchor, whether a forked eyelet or closed eyelet PEEK anchor, does not significantly influence the occur- rence of Popeye deformity. Level of Evidence: Level III, Therapeutic study.