{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:49:35Z","timestamp":1791470975296,"version":"4.3.4"},"reference-count":43,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Extracortical single-button (SB) inlay repair is a commonly used distal biceps tendon technique. However, complications (eg, neurovascular injury) and nonanatomic repairs have led to the development of intracortical fixation techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare the biomechanical stability of extracortical SB repair with an anatomic intracortical double-button (DB) repair technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The distal biceps tendon was transected in 18 cadaveric elbows from 9 donors. One elbow of each donor was randomly assigned to the extracortical SB or anatomic DB group. Both groups were cyclically loaded with 60 N over 1000 cycles between 90\u00b0 of flexion and full extension. The elbow was then fixed in 90\u00b0 of flexion and the repair construct loaded to failure. Gap formation and construct stiffness during cyclic loading and ultimate load to failure were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>When compared with the extracortical SB technique after 1000 cycles, the anatomic DB technique showed significantly less gap formation (mean \u00b1 SD, 2.7 \u00b1 0.8 vs 1.5 \u00b1 0.9 mm; P = .017) and significantly more construct stiffness (87.4 \u00b1 32.7 vs 119.9 \u00b1 31.6 N\/mm; P = .023). Ultimate load to failure was not significantly different between the groups (277 \u00b1 93 vs 285 \u00b1 135 N; P = .859). The failure mode in the anatomic DB group was significantly different from that of the extracortical SB technique ( P = .002) and was due to fracture avulsion of the cortical button in 7 of 9 specimens (vs none in the SB group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Our study shows that the intracortical DB technique produces equivalent or superior biomechanical performance to that of the SB technique. The DB technique may offer a clinically viable alternative to the SB repair technique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This study suggests, at worst, an equivalent and, at best, a superior biomechanical performance of intracortical anatomic DB footprint repair at the time of surgery. However, the mode of failure suggests that this technique should not be used in patients with poor bone quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465231171131","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T10:11:24Z","timestamp":1684145484000},"page":"1895-1903","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Biomechanical Comparison of Distal Biceps Tendon Repair Techniques: Extracortical Single-Button Inlay Fixation Versus Intracortical Double-Button Onlay Anatomic Footprint Fixation"],"prefix":"10.1177","volume":"51","author":[{"given":"Lukas","family":"Ernstbrunner","sequence":"first","affiliation":[{"name":"Melbourne Orthopaedic Group, Melbourne, Australia"},{"name":"Hand and Wrist Biomechanics Laboratory, O\u2019Brien Institute \/ St Vincent\u2019s Institute, Fitzroy, Australia"},{"name":"Department of Biomedical Engineering, 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