肱二头肌长头腱转位固定术与切断术治疗巨大肩袖撕裂的疗效比较

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Abstract Objective To compare the clinical outcomes of arthroscopic transpositive tenodesis and tenontotomy of biceps tendon in treating massive rotator cuff tears.Methods From March 2018 to August 2020，a total of 44 patients with massive rotator cuff tear received arthroscopic rotator cuff repair surgery in Civil Aviation General Hospital，and the data were retrospectively analyzed.The patients included 15 males and 29 females and aged 40~80 years，with an average age of (63.1±8.4)years.There were 21 patients in transpositive tenodesis group，and 23 patients in tenontotomy group.All the patients were diagnosed as anterior-superior or posterior-superior massive rotator cuff tears based on MRI and arthroscopy images.The postoperative follow ups were conducted in the 1st，3rd and 12th months.Both groups were evaluated according to the range of motion(ROM)，visual analogue scale(VAS)，University of California Los Angeles(UCLA) scores and Constant-Murley scores before and after the surgery.The conditions of rotator cuff healing and acromio-humeral interval (AHI)were assessed using magnetic resonance imaging(MRI).Results 44 cases were followed up for 11 to 13 months，with an average of (12.1±0.4)months.In the transpositive tenodesis group 12 months after operation，the VAS score decreased from (7.6±1.4)points before surgery to (1.1±1.8)points afer surgery，the UCLA score increased from (14.8±6.7)points before surgery to (32.1±4.9)points，after surgery，the Constant-Murley score increased from (52.4±21.4)points before surgery to (92.8±13.0)points afer surgery，the AHI increased from (6.0±1.6)mm before surgery to (8.5±1.1)mm after surgery.All the difference were statistically significant (P＜0.05).In the tenontotomy group 12 months after operation，the VAS score decreased from (7.7±1.4)points to (1.0±1.3)points，the UCLA score increased from (13.6±5.2)points to (32.9±2.7)points，the ConstantMurley score increased from (51.2±23.0)points to (95.2±6.4)points after surgery.All the difference were statistically significant (P＜0.05).Although the AHI increased from preoperative (5.8±1.6)mm to postoperative (6.3±1.3)mm in the tenontotomy group，there was no significant difference(P＞0.05).There were no significant differences in range of motion，the VAS score，the UCLA score and the ConstantMurley score between 2 groups 12 months after operation (P＞0.05)，while the AHI of tenontotomy group was much less than that of transpositive tenodesis group (P＜0.001).Although there were 2 cases of rotator cuff retear in tenontotomy group and no case of rotator cuff retear in transpositive tenodesis group，no statistical difference was observed(P＞0.05).Conclusion Both arthroscopic transpositive tenodesis and tenontotomy of biceps tendon can achieve satisfactory clinical outcomes in treating massive rotator cuff tears.Without increasing surgical difficulty obviously，arthroscopic transpositive tenodesis of biceps tendon can improve mechanical strength of rotator cuff and get better subacromial space.

Key words： massive rotator cuff tears rotator cuff repair long head of biceps tendon tendon transfer tenotomies

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	Ma Dong
	Yuan Bo
	Li Yumin

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Ma Dong,Yuan Bo,Li Yumin. Comparison of Transpositive Tenodesis and Tenontotomy of Biceps Tendon in Treating Massive Rotator Cuff Tears[J]. sygkzz, 2022, 28(8): 679-685.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I8/679

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