Patzer Thilo, Kircher Jörn, Krauspe Ruediger
Department of Orthopaedics, University Hospital of Düsseldorf, Düsseldorf, Germany.
Arthrosc Tech. 2012 Apr 6;1(1):e53-6. doi: 10.1016/j.eats.2012.01.003. Print 2012 Sep.
Arthroscopic suprapectoral techniques for tenodesis of the long head of the biceps tendon (LHB) are appropriate for the treatment of proximal biceps lesions. Several types of techniques and fixation devices have been described and evaluated in biomechanical studies regarding primary stability. In this technical note, we describe an all-arthroscopic suprapectoral technique using the 6.25-mm Bio-SwiveLock device (Arthrex, Naples, FL) for an interference screw-like bony fixation after having armed the tendon with a lasso-loop stitch. Both the interference screw fixation and securing of the lasso-loop tendon have been well described and approved in biomechanical tests concerning the primary stability. One advantage of this technique performed from the glenohumeral space, in addition to the strong and secure fixation with ingrowth of the tendon in a bony canal, is the avoidance of touching the soft tissue above the bicipital groove, which results in a smooth fitting of the tendon into its natural canal and therefore avoids mechanical irritation of the stump at the rotator interval. In conclusion, the all-arthroscopic suprapectoral LHB tenodesis performed from the glenohumeral space with the modified lasso-loop stitch for securing of the tendon and the 6.25-mm Bio-SwiveLock suture anchor for interference screw-like bony tendon fixation is an appropriate technique for the treatment of LHB-associated lesions.
关节镜下胸上肌技术用于肱二头肌长头肌腱（LHB）的固定术适用于治疗肱二头肌近端损伤。在关于初始稳定性的生物力学研究中，已经描述并评估了几种技术和固定装置。在本技术说明中，我们描述了一种全关节镜下胸上肌技术，该技术使用6.25毫米生物旋转锁定装置（Arthrex，那不勒斯，佛罗里达州），在使用套索环缝线将肌腱武装后进行类似干涉螺钉的骨固定。干涉螺钉固定和套索环肌腱的固定在关于初始稳定性的生物力学测试中都有很好的描述和认可。除了在骨管中通过肌腱长入实现牢固可靠的固定外，从盂肱间隙进行该技术的一个优点是避免接触肱二头肌沟上方的软组织，这使得肌腱能够顺利地进入其自然通道，从而避免了对旋转间隙处残端的机械刺激。总之，从盂肱间隙进行的全关节镜下胸上肌LHB固定术，采用改良的套索环缝线固定肌腱，以及6.25毫米生物旋转锁定缝线锚钉进行类似干涉螺钉的骨肌腱固定，是治疗与LHB相关损伤的一种合适技术。
