Bassett Shoulder and Sports Medicine Research Institute, Division of Orthopaedics, Bassett Healthcare Network, Cooperstown, New York, USA.
Am J Sports Med. 2011 Apr;39(4):857-65. doi: 10.1177/0363546510387512. Epub 2010 Dec 28.
Similar subjective outcomes have been reported for tenotomy or tenodesis of the long head of the biceps. Few studies have reported on postoperative strength and endurance.
Biceps tenodesis results in superior subjective outcomes, strength, and endurance compared with tenotomy.
Cohort study; Level of evidence, 3.
Participants completed isokinetic strength and endurance testing for elbow flexion and supination on the operative and nonoperative sides a minimum of 2 years after biceps tenotomy or tenodesis. Modified American Shoulder and Elbow Surgeons (MASES) and Single Assessment Numeric Evaluation (SANE) scores were obtained. The operative/nonoperative strength and endurance scores were compared for the tenotomy and tenodesis groups, with the nonoperative shoulder serving as the control for each participant's operative shoulder. Change scores for strength and endurance were reported as percentage increase or decrease as compared with the nonoperative side. Change scores and MASES and SANE scores were compared between the 2 groups. The presence of a "popeye" deformity or pain at the tenodesis site was noted.
Thirty-five patients (19 tenotomy, 16 tenodesis) were studied. No significant difference was noted in postoperative MASES and SANE scores. Operative-side peak supination torque was significantly decreased relative to the nonoperative side in the tenotomy group, which had a significantly larger decrease in supination peak torque than did the tenodesis group on comparison of change scores. No significant difference was noted for peak flexion torque or flexion/supination endurance between operative and nonoperative sides in either group or between change scores for peak flexion torque or flexion/supination endurance in the tenotomy and tenodesis groups. Four tenotomy patients had a popeye deformity, 2 of whom reported painful cramping. Two patients had pain at the tenodesis site.
Subjective outcomes are similar for patients treated with tenotomy and tenodesis. Tenotomy decreases supination peak torque relative to the nonoperative side and tenodesis.
对于肱二头肌长头肌腱切断术或肌腱固定术，已有类似的主观结果报道。很少有研究报告术后力量和耐力的情况。
与肌腱切断术相比，肱二头肌肌腱固定术可获得更好的主观结果、力量和耐力。
队列研究；证据水平，3 级。
至少在肱二头肌肌腱切断术或肌腱固定术后 2 年，参与者对手术侧和非手术侧的肘部弯曲和旋前进行等速力量和耐力测试。获得改良美国肩肘外科医师（MASES）和单项评估数值评估（SANE）评分。比较肌腱切断术和肌腱固定术组的手术/非手术侧力量和耐力评分，每位参与者的手术肩以非手术肩为对照。将力量和耐力的变化评分报告为与非手术侧相比的增加或减少的百分比。比较两组间的变化评分以及 MASES 和 SANE 评分。注意肌腱固定术部位是否存在“蛤蟆眼”畸形或疼痛。
共 35 例患者（19 例肌腱切断术，16 例肌腱固定术）参与研究。术后 MASES 和 SANE 评分无显著差异。与非手术侧相比，肌腱切断术组的手术侧旋后峰值扭矩显著降低，且与肌腱固定术组相比，变化评分的旋后峰值扭矩下降幅度更大。两组中，手术侧和非手术侧的峰值屈肌扭矩或屈肌/旋后耐力均无显著差异，肌腱切断术和肌腱固定术组的峰值屈肌扭矩或屈肌/旋后耐力的变化评分也无显著差异。4 例肌腱切断术患者出现“蛤蟆眼”畸形，其中 2 例报告疼痛性痉挛。2 例患者肌腱固定术部位疼痛。
肌腱切断术和肌腱固定术治疗的患者主观结果相似。与非手术侧相比，肌腱切断术会降低旋后峰值扭矩，而肌腱固定术则不会。
