Yong Girl Rhee, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea.
Am J Sports Med. 2014 May;42(5):1161-8. doi: 10.1177/0363546514523719. Epub 2014 Feb 27.
There is no clear consensus regarding optimal management of lesions of the long head of the biceps tendon (LHBT) associated with rotator cuff tears.
To compare clinical outcome and cosmetic deformity of a funnel tenotomy versus intracuff tenodesis for concomitant LHBT lesion in patients with rotator cuff tears.
Cohort study; Level of evidence, 3.
Patients who underwent surgical treatment for rotator cuff tears associated with LHBT lesions between March 2005 and February 2011 were enrolled in the study (N = 83). Forty-one underwent a funnel tenotomy (group A), and 42 underwent an intracuff tenodesis (group B). The mean age at the time of operation was 63.8 years in group A (range, 44-68 years) and 58.6 years in group B (range, 45-70 years).
At the most recent follow-up, the mean University of California at Los Angeles (UCLA) score in group A improved from a preoperative mean of 16.9 ± 3.6 to 30.6 ± 4.1 (P < .001), and the Constant score improved from 58.7 ± 14.2 to 73.8 ± 11.2 (P < .001). In group B, these scores improved from 18.1 ± 4.0 to 31.3 ± 3.0 (P < .001) and 53.6 ± 13.4 to 74.8 ± 11.9 (P < .001), respectively. There were no statistically significant differences between the 2 groups (P = .43 for UCLA, P = .81 for Constant score). Popeye deformity was detected in 11 cases of group A (26.8%) and in 7 cases of group B (16.7%) (P = .06).
For the treatment of concomitant LHBT lesions in patients with rotator cuff tears, both a funnel tenotomy and an intracuff tenodesis showed good clinical outcomes. Even though the incidence of Popeye deformity in the funnel tenotomy group tended to be higher, there was no significant difference in the overall incidence of cosmetic deformity between the 2 groups.
对于伴有肩袖撕裂的长头肌腱（LHBT）病变的最佳处理方法，目前尚无明确共识。
比较漏斗状肌腱切开术与肩袖下肌腱内固定术治疗伴有 LHBT 病变的肩袖撕裂患者的临床疗效和美容畸形。
队列研究；证据水平，3 级。
2005 年 3 月至 2011 年 2 月期间，对接受手术治疗的伴有 LHBT 病变的肩袖撕裂患者进行了研究（N=83）。41 例行漏斗状肌腱切开术（A 组），42 例行肩袖下肌腱内固定术（B 组）。A 组患者手术时的平均年龄为 63.8 岁（4468 岁），B 组为 58.6 岁（4570 岁）。
末次随访时，A 组患者的加利福尼亚大学洛杉矶分校（UCLA）评分从术前的 16.9±3.6 分提高到 30.6±4.1 分（P<.001），Constant 评分从 58.7±14.2 分提高到 73.8±11.2 分（P<.001）。B 组患者的这两项评分分别从 18.1±4.0 分提高到 31.3±3.0 分（P<.001）和 53.6±13.4 分提高到 74.8±11.9 分（P<.001）。两组间差异无统计学意义（UCLA 评分，P=.43；Constant 评分，P=.81）。A 组有 11 例（26.8%）和 B 组有 7 例（16.7%）患者出现 Popeye 畸形（P=.06）。
对于伴有肩袖撕裂的 LHBT 病变患者，漏斗状肌腱切开术和肩袖下肌腱内固定术均可获得良好的临床疗效。虽然漏斗状肌腱切开术组 Popeye 畸形的发生率较高，但两组间美容畸形的总发生率无显著差异。
