Szabó Istvan, Boileau Pascal, Walch Gilles
Department of Orthopedic Surgery, Medical School, University of Pécs, Pécs, Hungary.
Sports Med Arthrosc Rev. 2008 Sep;16(3):180-6. doi: 10.1097/JSA.0b013e3181824f1e.
Many palliative interventions have been proposed for patients in whom rotator cuff repair is not feasible as a result of advanced fatty infiltration, definitive loss of tendons, and proximal humeral migration. The long head of the biceps tendon has been proposed as a source of pain in patients with rotator cuff tears. This article presents a review of current concepts on the rationale for arthroscopic biceps tenotomy or tenodesis, and evaluates the objective, subjective, and radiographic results of these palliative procedures. On the basis of different studies, it seems that isolated arthroscopic biceps tenotomy or tenodesis is a valuable option for the treatment of rotator cuff tears in selected patients. Although it does not improve shoulder strength, tenotomy or tenodesis reduces pain and improves the functional range of motion with a high degree of patient satisfaction. However, the progressive radiographic changes that occur with long standing rotator cuff tears are not altered.
对于因脂肪浸润严重、肌腱完全丧失以及肱骨头近端移位而无法进行肩袖修复的患者，已提出多种姑息性干预措施。肱二头肌长头已被认为是肩袖撕裂患者疼痛的一个来源。本文综述了关节镜下肱二头肌肌腱切断术或肌腱固定术的理论依据的当前概念，并评估了这些姑息性手术的客观、主观和影像学结果。基于不同的研究，对于选定患者，单纯关节镜下肱二头肌肌腱切断术或肌腱固定术似乎是治疗肩袖撕裂的一个有价值的选择。虽然它不能提高肩部力量，但肌腱切断术或肌腱固定术可减轻疼痛并改善功能活动范围，患者满意度较高。然而，长期肩袖撕裂所发生的渐进性影像学改变并未改变。
