两种手术方式治疗高龄肩袖损伤合并肱二头肌腱长头腱损伤疗效比较

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1851 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To systematically evaluate the early effect of rotator cuff repair combined with tenotomy or tenodesis of long head of the biceps tendon in elderly patients.Methods The clinical data of 82 patients over 70 years old who underwent shoulder cuff repair combined with biceps longhead tendon surgery under arthroscopy were analyzed retrospectively from June 2015 to December 2019.37 cases (37 shoulders) were included in the fixation group，including 15 males and 22 females.The patients were 71~87 years old，with an average age of (74.3±4.4)years；45 cases (45 shoulders) who underwent long head tendon resection were included in the amputation group，including18 males and 27 females.The patientswere 70~88 yearsold，with an average age of (76.1±5.2)years.The operation time，biceps related complications (popeye deformity，biceps spasm，upper arm pain，etc.)，recent complications of operation (infection，wound problems，fracture，neurovascular injury，death，etc.)，the American shoulder and elbow surgeons(ASES) score 12 months after operation，Disability of arm，shoulder and hand(DASH) and the MOS 36-item short-form health survey(SF-36) were compared.Results All patients were followed up for 13~18 months.The operation time of the fixation group was (73.76±32.37) min，which was significantly longer than that of the amputation group (57.67±21.83) min (P＝0.021).The incidence of biceps related complications was 5.4% (2/37) and the recent complications of operation was 13.4%(5/37) in fixation group；the incidence of biceps related complications was 17.8%(8/45) and the recent complications of operation was 6.7%(3/45) in amputation group.Twelvemonths after operation，the ASES score and DASH score of fixation group and amputation group were (86.7±4.4)，(83.9±11.1) and (8.5±4.2)，(9.7±1.9) respectively，and there was no significant difference between the two groups (P＞0.05).The scores of physical function，physical function，physical pain and general health status in the fixed group were significantly higher than those in the amputated group (P＜0.05).There was no significant difference in vitality，social function，emotional function and mental health between the two groups.Conclusion Elderly patients with rotator cuff suture fixation and direct cut off the long head of biceps brachii tendon can achieve excellent clinical efficacy after one year；compared with the cut-off operation，the probability of biceps related complications after fixation operation is lower，but the probability of early surgical complications is higher，the quality of life is higher，and the selfcare ability is stronger.

Key words： rotator cuff repair long head of biceps complications

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2021/V27/I7/577

［1］Sarmento M.Long head of biceps：from anatomy to treatment［J］.Acta Reumatol Port，2015，40(1)：26-33.
［2］Riley GP，Harrall RL，Constant CR，et al.Glycosaminoglycans of human rotator cuff tendons：changes with age and in chronic rotator cuff tendinitis［J］.Ann Rheum Dis，1994，53(6)：367-376.
［3］Pozzetti Daou J，Nagaya DY，Matsunaga FT，et al.Does biceps tenotomy or tenodesis have better results after surgery?A systematic review and Meta-analysis［J］.Clin Orthop Relat Res，2021(479)：1561-1573.
［4］Verma N.In adults with lesions of the long head of the biceps tendon，tenodesis and tenotomy did not differ for pain and function at 2 years［J］.J Bone Joint Surg (Am)，2021，103(4)：357.
［5］Zhou P，Liu J，Deng X，et al.Biceps tenotomy versus tenodesis for lesions of the long head of the biceps tendon：A systematic review and meta-analysis of randomized controlled trials［J］.Medicine (Baltimore)，2021，100(3)：e23993.
［6］Aflatooni JO，Meeks BD，Froehle AW，et al.Biceps tenotomy versus tenodesis：patientreported outcomes and satisfaction［J］.J Orthop Surg Res，2020，15(1)：56.
［7］Meeks BD，Meeks NM，Froehle AW，et al.Patient satisfaction after biceps tenotomy［J］.Orthop J Sports Med，2017，5(5)：2325967117707737.
［8］Zhu XM，Leroux T，Ben-David E，et al.A meta-analysis of level I evidence comparing tenotomy vs tenodesis in the management of long head of biceps pathology［J］.J Shoulder Elbow Surg，2021，30(5)：961-968.
［9］唐步顺，曹学成，张抒.带线锚钉治疗肱二头肌长头腱断裂［J］.骨科，2012，3(1)：3.
［10］Tahal DS，Katthagen JC，Vap AR，et al.Subpectoral biceps tenodesis for tenosynovitis of the long head of the biceps in active patients younger than 45 years old［J］.Arthroscopy，2017，33(6)：1124-1130.
［11］Netuveli G，Wiggins RD，Hildon Z，et al.Quality of life at older ages：evidence from the English longitudinal study of aging (wave 1)［J］.J Epidemiol Community Health，2006，60(4)：357-363.
［12］李真真，汤哲，王荣.中国7个城市老年人失能现状调查［J］.中华流行病学杂志，2016，37(12)：1561-1564.
［13］Friedman JL，FitzPatrick JL，Rylander LS，et al.Biceps tenotomy versus tenodesis in active patients younger than 55 years：Is there a difference in strength and outcomes?［J］.Orthop J Sports Med，2015，3(2)：2325967115570848.
［14］Corpus KT，Garcia GH，Liu JN，et al.Long head of biceps tendon management：A survey of the american shoulder and elbow surgeons［J］.HSS J，2018，14(1)：34-40.
［15］Morse KW，Eno JJ，Altchek DW，et al.Injuries of the biceps and superior labral complex in overhead athletes［J］.Curr Rev Musculoskelet Med，2019，12(2)：72-79.
［16］Elser F，Braun S，Dewing CB，et al.Anatomy，function，injuries，and treatment of the long head of the biceps brachii tendon［J］.Arthroscopy，2011，27(4)：581-592.
［17］Guttmann D.Editorial commentary：You may not have seen it，but it has seen you：Diagnosis of long head biceps tendon and subscapularis pathology in association with shoulder rotator cuff pathology can be challenging［J］.Arthroscopy，2017，33(11)：1977-1980.
［18］Ciccotti MG.Editorial Commentary：the long head of the biceps brachii tendonthe shoulder surgeon's conundrum［J］.Arthroscopy，2017，33(11)：1937-1939.
［19］DoostiIrani A，Nedjat S，Nedjat S，et al.Quality of life in Iranian elderly population using the SF-36 questionnaire：systematic review and metaanalysis［J］.East Mediterr Health J，2019，24(11)：1088-1097.
［20］Andersen WJ，Barcelos M，de Paiva Raffaelli M，et al.Ultrasound-Guided Suprapectoral Tenodesis of the Long Head of the Biceps Brachii［J］.Arthrosc Tech，2020，9(12)：e2071-e2076.
［21］Angelo RL.Surgical management of proximal long head biceps tendon disorders［J］.Sports Med Arthrosc Rev，2018，26(4)：176-180.

[1]	. [J]. sygkzz, 2021, 27(9): 765-767.