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Biceps tendon tenodesis for posterolateral instability of the knee

An in vitro study

Biomechanics Research Section, UCLA Division of Orthopaedic Surgery, Los Angeles, California

J. David Grauer, MD

Biomechanics Research Section, UCLA Division of Orthopaedic Surgery, Los Angeles, California

Keith L. Markoff, MD

Biomechanics Research Section, UCLA Division of Orthopaedic Surgery, Los Angeles, California

The effects of biceps tendon tenodesis on internal- external and varus-valgus laxity were measured using fresh-frozen cadaveric specimens that had undergone sequential sectioning of the posterolateral structures and of the fibular collateral ligament. Tenodesis (using 89 N graft tension and a fixation point located 1 cm anterior to the fibular collateral ligament's insertion on the femur) was effective in restoring external rotation and varus laxity; the procedure actually overcon strained external tibial rotation at all flexion positions and varus angulation at 60° and 90° of flexion. Internal rotation and valgus laxity were unaffected by the teno desis procedure. The anterior fixation point was more effective in reducing laxity than a fixation point located 1 cm proximal to the fibular collateral ligament insertion. Tenodesis using the proximal fixation point, which was nonisometric, did not restore external rotation and varus laxities to intact values at 60° and 90° of knee flexion. Graft tension (45 or 89 N) had no measurable effect on the results of the tenodesis. This study has demonstrated that the biceps tenodesis procedure is effective for reducing static laxity in the knee with posterolateral instability.

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