Murthi A M, Vosburgh C L, Neviaser T J
Department of Orthopaedic Surgery, George Washington University Medical Center, Washington, DC, USA.
J Shoulder Elbow Surg. 2000 Sep-Oct;9(5):382-5. doi: 10.1067/mse.2000.108386.
The incidence of primary and secondary bicipital tendinitis remains unknown. In our prospective study, 200 consecutive shoulders underwent arthroscopic subacromial decompression for impingement syndrome. A biceps tenodesis was performed in 80 shoulders (40%) featuring macroscopic degeneration of the long head of the biceps; rotator cuff tears were apparent in 91% of these shoulders, the mean patient age being 55 years. In each of 120 shoulders (60%), an extraarticular tenosynovectomy was performed, and histopathologic studies revealed chronic inflammation in 63% and fibrotic degeneration in 13% of the specimens; rotator cuff tears were evident in 70% (23% full thickness) of these cases, the mean patient age being 47 years. In addition, when glenohumeral arthritis was present, it was uniformly associated with pathologic biceps tenosynovium. In summary, the high incidence of chronic inflammation of the long head of the biceps in shoulders with benign-appearing intraarticular portions viewed arthroscopically is significant, and long head of the biceps disease should also be considered in patients with painful rotator cuff disease and arthritic shoulder conditions.
原发性和继发性肱二头肌肌腱炎的发病率尚不清楚。在我们的前瞻性研究中，连续200例肩部因撞击综合征接受了关节镜下肩峰下减压术。80例肩部（40%）因肱二头肌长头出现肉眼可见的退变而进行了肱二头肌肌腱固定术；这些肩部中91%存在肩袖撕裂，患者平均年龄为55岁。在120例肩部（60%）中，每例均进行了关节外腱鞘切除术，组织病理学研究显示，63%的标本存在慢性炎症，13%存在纤维化退变；这些病例中70%（23%为全层）存在肩袖撕裂，患者平均年龄为47岁。此外，当存在盂肱关节炎时，均与病理性肱二头肌腱鞘相关。总之，在关节镜下关节内部分看似正常的肩部中，肱二头肌长头慢性炎症的高发病率具有重要意义，对于有疼痛性肩袖疾病和关节炎性肩部疾病的患者，也应考虑肱二头肌长头疾病。
