Effect of insertion process on biceps tendon reconstruction in BASHTI technique: An in-vitro study

Bone And Site Hold Tendon Inside (BASHTI) implant-less technique is proposed as an alternative to conventional tendon repair methods. This study aims to evaluate the strength of this technique under biceps loading conditions with different xation strategies. Twelve specimens with bovine tendons and Sawbones were constructed using two different insertion methods; in Group 1, 4 samples were prepared using a hand-hammer with a hitting frequency of 300 Beats Per Minute (BPM), while Group 2 included eight specimens with insertion using an auto-hammer applying a frequency of 3600 BPM. Both of the groups were tested under cyclic loading, followed by a pull-out until the failure. All the samples completed the cyclic step without failure. At the pull-out step, for Group 1, the strength and sti ness were 251±31 N and 10:3±0:8 N/mm, respectively, while these values were 183±35 N and 10:5±3:0 N/mm, respectively, for Group 2. It was concluded that the BASHTI structure for biceps tendon reconstruction had a proper strength and the insertion process had no effect on its behavior under cyclic loading. It was also proved that variations in the insertion frequency significantly affected the maximum strength of the structure (p-value = 0.038). Still, its influence on the sti ness was insignificant (p-value = 0.91).