Initial evidence suggests biceps tenodesis location may not significantly affect glenohumeral joint stress or humeral head translation during late cocking and deceleration in throwing: a finite element analysis.

Abstract

Biceps tenodesis is widely used for type II superior labrum anterior posterior lesions in high-performance athletes, yet the influence of tenodesis location-articular margin, suprapectoral, or subpectoral-on glenohumeral joint biomechanics during overhead throwing remains poorly understood. This study explores stress and humeral head translation in late cocking and deceleration phases. Eight finite element analysis (FEA) models were created using computed tomography and magnetic resonance imaging data from normal glenohumeral joints. The late cocking and deceleration phases of overhead throwing were simulated for uninjured with an intact long head of the biceps tendon and articular margin, suprapectoral, and subpectoral tenodesis. Stress distributions in the cartilage, labrum, capsule, and humeral head translation of the 3 tenodesis models were studied and compared. Stress difference exceeding 5 MPa or humeral head translation surpassing 1.0 mm was considered significant. FEA showed that the magnitudes of the contact stress varied among models, affecting cartilage and soft tissues differently. Humeral head translation was most restricted in the articular margin tenodesis model, with a distance of 2.95 mm, followed by the suprapectoral and subpectoral models at 3.14 mm and 3.60 mm, respectively. The differences in stress and humeral head translation were not significant between models. FEA findings suggest that there may be minimal variations in stress on the glenohumeral joint and humeral head translation during the late cocking and deceleration phases of overhead throwing when comparing articular margin, suprapectoral, and subpectoral biceps tenodesis models.