Frost Andrew, Zafar Mohammed Saqib, Maffulli Nicola
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, Stoke on Trent, Staffordshire, England.
Am J Sports Med. 2009 Apr;37(4):828-33. doi: 10.1177/0363546508322179. Epub 2008 Sep 1.
Primary and secondary lesions of the tendon of the long head of the biceps brachii are common, with no clear consensus about their optimal management.
There is no difference in outcomes of tenotomy and tenodesis for lesions of the tendon of the long head of the biceps brachii.
We performed a comprehensive quantitative review of the published English-language literature comparing the outcomes of tenotony and tenodesis for lesions of the tendon of the long head of the biceps brachii.
All relevant articles in peer-reviewed journals were retrieved, and each article was scored using the Coleman Methodology Score, a highly repeatable methodology score, by 2 independent reviewers.
Scores were predominantly low for quality of the studies, with patient number and validated outcome measures being the weakest areas.
There is a lack of quality evidence to advocate one technique over the other. We emphasize the need for appropriately powered, well-conducted, randomized, controlled trials comparing the outcomes of these 2 procedures. There is little difference in the outcome of tenotomy compared with tenodesis. Tenotomy is easy and quick, with less need for postoperative rehabilitation. We therefore suggest that biceps tenotomy be the preferred method. Clinical Relevance Biceps pathologic lesions are common. There is no evidence base for their most appropriate management.
肱二头肌长头肌腱的原发性和继发性损伤很常见，对于其最佳治疗方法尚无明确共识。
肱二头肌长头肌腱损伤的腱切断术和腱固定术的疗效无差异。
我们对已发表的英文文献进行了全面的定量综述，比较了肱二头肌长头肌腱损伤的腱切断术和腱固定术的疗效。
检索同行评审期刊中的所有相关文章，由2名独立评审员使用高度可重复的方法评分——科尔曼方法评分对每篇文章进行评分。
研究质量得分大多较低，患者数量和经过验证的结局指标是最薄弱的环节。
缺乏高质量证据支持一种技术优于另一种技术。我们强调需要进行有足够样本量、实施良好的随机对照试验来比较这两种手术的疗效。腱切断术与腱固定术的疗效差异不大。腱切断术简单快捷，术后康复需求较少。因此，我们建议肱二头肌腱切断术为首选方法。临床相关性：肱二头肌病理性损伤很常见。对于其最恰当的治疗方法尚无循证依据。
