Voss Andreas, Cerciello Simone, DiVenere Jessica, Solovyova Olga, Dyrna Felix, Apostolakos John, Lam David, Cote Mark P, Beitzel Knut, Mazzocca Augustus D
Department of Orthopaedic Surgery, University of Connecticut Health Center, Farmington, CT, USA.
Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
BMC Musculoskelet Disord. 2017 Nov 6;18(1):430. doi: 10.1186/s12891-017-1780-1.
Long head biceps tendon pathology is a common cause of anterior shoulder pain and is often associated with other shoulder conditions, such as rotator cuff tears and osteoarthritis. It is well accepted that older patients are at increased risk for major and minor peri- and postoperative complications. The purpose of this study is to investigate patients over 65 years old who underwent subpectoral biceps tenodesis and compare the complication rates of this group to those of patients younger than 65 years old. The hypothesis is, that there would be no difference in complication rates and that clinical outcome scores for patients over 65 were satisfying and showed improvements over time.
There were 337 patients who underwent open subpectoral biceps tenodesis, between January 2005 and June 2015, 23 were identified as being over the age of 65 with a minimum follow up of 12 months. All patients over the age of 65 were evaluated pre- and postoperatively using Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM) and Single Assessment Numeric Evaluation (SANE). Intraoperative and postoperative adverse events (fracture, infection, wound opening, rupture/failure and neurovascular injuries) related to the tenodesis procedure and to the surgery itself were collected from all 337 patients in a routine postoperative follow-up.
The under 65 group (range 27-64 years) at an average follow up (FU) of 30 months (range 12-91 months) showed a 5.4% (17 out of 314) post-operative complication rate related to the subpectoral tenodesis, whereas the group over 65 (range 65-77 years) at an average follow up of 33 months (range 12-79 months) showed an 8.7% (2 out of 23) complication rate.
This study demonstrates that in patients over the age of 65, biceps tenodesis is a successful procedure when performed for biceps tendinopathy and concomitantly with other surgical procedures of the shoulder, and does not result in an increased rate of complications when compared to a group of patients under the age of 65.
肱二头肌长头肌腱病变是肩部前方疼痛的常见原因，且常与其他肩部疾病相关，如肩袖撕裂和骨关节炎。众所周知，老年患者发生严重及轻微围手术期和术后并发症的风险更高。本研究的目的是调查65岁以上接受胸大肌下肱二头肌固定术的患者，并将该组患者的并发症发生率与65岁以下患者的并发症发生率进行比较。假设是，并发症发生率无差异，且65岁以上患者的临床结局评分令人满意且随时间推移有所改善。
2005年1月至2015年6月期间，有337例患者接受了开放性胸大肌下肱二头肌固定术，其中23例被确定为65岁以上，且至少随访12个月。所有65岁以上的患者在术前和术后均使用简单肩部测试（SST）、美国肩肘外科医师协会（ASES）、Constant-Murley（CM）和单评估数字评价（SANE）进行评估。在常规术后随访中，从所有337例患者中收集与固定术及手术本身相关的术中及术后不良事件（骨折、感染、伤口裂开、破裂/失败和神经血管损伤）。
65岁以下组（年龄范围27 - 64岁）平均随访（FU）30个月（范围12 - 91个月），与胸大肌下固定术相关的术后并发症发生率为5.4%（314例中的17例），而65岁以上组（年龄范围65 - 77岁）平均随访33个月（范围12 - 79个月），并发症发生率为8.7%（23例中的2例）。
本研究表明，对于65岁以上的患者，肱二头肌固定术在治疗肱二头肌肌腱病并同时进行肩部其他外科手术时是一种成功的手术，与65岁以下的患者组相比并不会导致并发症发生率增加。
