From CU Sports Medicine, Department of Orthopedics, University of Colorado School of Medicine, Boulder, CO (Dr. Frank), the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL (Mr. Cotter and Dr. Romeo), and New York University, Langone Medical Center, New York, NY (Dr. Strauss and Dr. Jazrawi).
J Am Acad Orthop Surg. 2018 Feb 15;26(4):e77-e89. doi: 10.5435/JAAOS-D-17-00085.
Management of proximal and distal biceps tendon pathology is evolving. The long head of the biceps tendon, if inflamed, may be a pain-producing structure. In appropriately indicated patients, a symptomatic long head of the biceps tendon can be surgically managed via tenotomy, tenodesis, and/or superior labrum anterior to posterior repair. In some patients, primary superior labrum anterior to posterior pathology can be managed via biceps tenodesis. Determining which procedure is most appropriate and which technique and implant are preferred for a given patient with biceps tendon pathology is controversial. Less debate exists with regard to the timing of distal biceps tendon repair; however, considerable controversy exists with regard to selection of an appropriate surgical technique and implant. In addition, the treatment of patients with a chronic and/or retracted distal biceps tendon tear and patients in whom distal biceps tendon repair fails is extremely challenging. Orthopaedic surgeons should understand the anatomy of, nonsurgical and surgical treatment options for, and outcomes of patients with proximal or distal biceps tendon pathology.
肱二头肌肌腱近端和远端病变的治疗方法正在不断发展。如果肱二头肌长头肌腱发炎，它可能成为产生疼痛的结构。在适当选择的患者中，有症状的肱二头肌长头肌腱可以通过肌腱切断术、肌腱固定术和/或上盂唇从前向后修复来进行手术治疗。在一些患者中，原发性上盂唇从前向后病变可以通过肱二头肌肌腱固定术来治疗。对于肱二头肌肌腱病变的特定患者，确定哪种手术最适合以及哪种技术和植入物最适合存在争议。对于肱二头肌远端肌腱修复的时机，争议较小；然而，对于选择合适的手术技术和植入物，存在相当大的争议。此外，治疗慢性和/或回缩的肱二头肌远端肌腱撕裂以及肱二头肌远端肌腱修复失败的患者极具挑战性。矫形外科医生应了解肱二头肌近端或远端肌腱病变患者的解剖结构、非手术和手术治疗选择以及患者的治疗结果。
