David Tal S, Schildhorn Jeffrey C
SportsMed Surgery Associates, San Diego, California, U.S.A.
Arthrosc Tech. 2012 Jul 21;1(1):e127-32. doi: 10.1016/j.eats.2012.05.004. Print 2012 Sep.
Tenodesis is an accepted treatment option in the management of pathology involving the long head of the biceps (LHB). Among the common causes for revision surgery after tenodesis are residual pain within the bicipital groove, cramping, early biceps fatigue, and biceps deformity. Most technical descriptions of arthroscopic biceps tenodesis involve fixation of the LHB tendon within or proximal to the intertubercular sulcus and thus fail to address the described sources of pain within this proximal anatomic location. Suprapectoral tenodesis offers the surgeon the ability to remove the LHB from within the bicipital groove by fixating the biceps more distally. Cramping, early fatigue, and biceps deformity have been described when the appropriate length-tension relation of the biceps tendon has not been restored after LHB tenodesis. Our described procedure allows for a more consistent restoration of the anatomic length-tension relation of the LHB, therefore reducing the symptoms associated with this variable. This all-arthroscopic, suprapectoral biceps tenodesis with interference fixation addresses the most common causes for revision surgery and offers a comprehensive solution for LHB pathology.
腱固定术是治疗涉及肱二头肌长头（LHB）病变的一种公认的治疗选择。腱固定术后翻修手术的常见原因包括肱二头肌沟内残留疼痛、痉挛、肱二头肌早期疲劳和肱二头肌畸形。大多数关节镜下肱二头肌腱固定术的技术描述都涉及将LHB肌腱固定在结节间沟内或其近端，因此未能解决该近端解剖位置内所述的疼痛来源。胸上腱固定术使外科医生能够通过在更远端固定肱二头肌将LHB从肱二头肌沟内移出。当LHB腱固定术后未恢复肱二头肌肌腱合适的长度-张力关系时，会出现痉挛、早期疲劳和肱二头肌畸形。我们所描述的手术方法能够更一致地恢复LHB的解剖长度-张力关系，从而减少与此变量相关的症状。这种采用干涉固定的全关节镜下胸上肱二头肌腱固定术解决了翻修手术的最常见原因，并为LHB病变提供了全面的解决方案。
