Gurnani Navin, van Deurzen Derek F P, Janmaat Vincent T, van den Bekerom Michel P J
Department of Orthopedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3765-3771. doi: 10.1007/s00167-015-3640-6. Epub 2015 May 15.
The objective of this meta-analysis is to compare clinical outcomes of tenotomy and tenodesis in the surgical treatment of long head of the biceps brachii (LHB).
A literature search was conducted in Embase and PubMed from 2000 to April 2014. All studies comparing the clinical outcomes between LHB tenotomy and tenodesis were included. The quality assessment was done by utilizing the Coleman score. We included nine studies comprising 650 patients undergoing LHB tenotomy or tenodesis, mostly with concomitant shoulder pathology.
No significant difference in post-operative Constant score (mean difference 1.77), elbow flexion strength (mean difference 0), and forearm supination strength (mean difference 0.01) in favour of tenodesis was observed. A Popeye deformity (odds ratio 0.17) and cramping pain (odds ratio 0.38) in the bicipital groove muscle were less frequently seen in patients treated with tenodesis. The Coleman score ranged between 45 and 100 in the included studies.
Based on this meta-analysis, no differences in post-operative functional outcome between tenotomy and tenodesis for the treatment of LHB lesions were observed. A Popeye deformity and cramping pain in the bicipital groove are more frequently observed in patients treated with tenotomy.
IV.
本荟萃分析的目的是比较肱二头肌长头（LHB）手术治疗中腱切断术和腱固定术的临床疗效。
于2000年至2014年4月在Embase和PubMed上进行文献检索。纳入所有比较LHB腱切断术和腱固定术临床疗效的研究。采用科尔曼评分进行质量评估。我们纳入了9项研究，共650例接受LHB腱切断术或腱固定术的患者，大多数伴有肩部病变。
未观察到在术后Constant评分（平均差异1.77）、肘关节屈曲力量（平均差异0）和前臂旋后力量（平均差异0.01）方面腱固定术有显著优势。接受腱固定术治疗的患者中，肱二头肌沟肌肉出现“大力水手”畸形（优势比0.17）和痉挛性疼痛（优势比0.38）的情况较少见。纳入研究的科尔曼评分在45至100之间。
基于本荟萃分析，未观察到腱切断术和腱固定术治疗LHB损伤术后功能结局存在差异。接受腱切断术治疗的患者中，更常观察到肱二头肌沟出现“大力水手”畸形和痉挛性疼痛。
IV级。
