Franceschi Francesco, Longo Umile Giuseppe, Ruzzini Laura, Papalia Rocco, Rizzello Giacomo, Denaro Vincenzo
Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Longoni, 83, 00155 Rome, Italy.
Int Orthop. 2007 Aug;31(4):537-45. doi: 10.1007/s00264-006-0206-8. Epub 2006 Sep 1.
The aim of this study was to determine whether or not detaching the biceps tendon from the glenoid after tenodesis performed with the inclusion of the biceps in the rotator cuff suture results in an improved outcome. From 1999 to 2001, 22 patients had an arthroscopic rotator cuff repair and associated biceps tendon lesions that were repaired with two new arthroscopic techniques of tenodesis incorporating the biceps tendon in the rotator cuff suture. Patients were randomised into one of two groups: tenodesis without tenotomy (group 1) and tenodesis with tenotomy (group 2). Preoperative and postoperative functions were assessed by means of a modified UCLA rating scale and shoulder ROM. The mean follow-up period was 47.2 months (range 36- 59). In group 1 (tenodesis without tenotomy), eight patients had an excellent postoperative score and three a good postoperative score. The UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative average rating of 10.5 (5-15) to the postoperative average score of 33 (29-35) (P<0.05). In group 2 (tenodesis with tenotomy), the UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative rating of 11.1 to the postoperative score of 32.9 (P<0.05). No statistically significant difference in the total UCLA scores was found when comparing the repairs performed with or without tenotomy. Follow-up results with regard to ROM were not different between the two groups, and the range of motion was improved in all measured directions. In this series, every patient qualified as having good to excellent results according to the UCLA score. This study suggests that there is no difference between detaching and not detaching the biceps after including it in the repair.
本研究的目的是确定在将肱二头肌纳入肩袖缝合进行固定术后，将肱二头肌肌腱从关节盂分离是否能改善治疗效果。1999年至2001年，22例患者接受了关节镜下肩袖修复及相关肱二头肌肌腱损伤修复，采用了两种新的关节镜下固定技术，即将肱二头肌肌腱纳入肩袖缝合。患者被随机分为两组：不进行肌腱切断的固定术（第1组）和进行肌腱切断的固定术（第2组）。术前和术后功能通过改良的加州大学洛杉矶分校（UCLA）评分量表和肩关节活动度（ROM）进行评估。平均随访期为47.2个月（范围36 - 59个月）。在第1组（不进行肌腱切断的固定术）中，8例患者术后评分优秀，3例良好。用于评估的UCLA评分系统显示，术前平均评分为10.5（5 - 15），术后平均评分为33（29 - 35），差异有统计学意义（P<0.05）。在第2组（进行肌腱切断的固定术）中，用于评估的UCLA评分系统显示，术前评分为11.1，术后评分为32.9，差异有统计学意义（P<0.05）。比较有无肌腱切断的修复手术时，UCLA总分无统计学显著差异。两组在ROM方面的随访结果无差异，所有测量方向的活动度均有改善。在本系列研究中，根据UCLA评分，每位患者的结果均为良好至优秀。本研究表明，在修复中纳入肱二头肌后，分离与不分离肱二头肌之间没有差异。
