Kumar Chouhan Devendra, Rakesh John, Tungish Bansal, Singh Dhillon Mandeep
Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Muscles Ligaments Tendons J. 2018 Jan 10;7(3):562-569. doi: 10.11138/mltj/2017.7.3.562. eCollection 2017 Jul-Sep.
Multiple reports of congenitally absent long head of biceps tendon (LHBT) have been reported in the literature. However, there is no consensus on the clinical implications of this relatively rare entity.
To systematically review and analyze all studies which have reported absence of LHBT.
PubMed and EMBASE databases were searched. Also, a secondary search was performed by pearling the bibliography of all the full-text articles obtained. Pre defined inclusion criteria was used for abstract screening by two independent observers. Twenty three studies met our inclusion criteria, were included for the final analysis and the data was pooled. The cases were further sub-grouped according to the classification of Dierickx et al.
Till date, 35 cases of absent LHBT have been reported. Males and females were equally affected. Eight of these were bilateral and only four cases had other associated congenital anomalies. Majority of the patients presented with shoulder pain (85.7%) while 37.1% had shoulder instability (mainly anterior instability). The ABS type was the most common variant reported. The finding was missed in 60% of the cases on the initial MRI only to be detected later on shoulder arthroscopy.
Congenitally absent LHBT may not be as rare as was previously thought to be. Due to the heterogeneity and the low level of evidence of the data available, it is hard to conclude if a congenitally absent LHBT is a cause of shoulder pain/impingement or instability on its own.
IV.
文献中已有多例关于肱二头肌长头肌腱（LHBT）先天性缺如的报道。然而，对于这种相对罕见的情况的临床意义尚无共识。
系统回顾和分析所有报道LHBT缺如的研究。
检索了PubMed和EMBASE数据库。此外，通过梳理所有获得的全文文章的参考文献进行了二次检索。由两名独立观察者使用预先定义的纳入标准进行摘要筛选。23项研究符合我们的纳入标准，被纳入最终分析并汇总数据。根据Dierickx等人的分类对病例进行进一步分组。
迄今为止，已报道35例LHBT缺如病例。男性和女性受影响程度相同。其中8例为双侧，只有4例有其他相关先天性异常。大多数患者表现为肩部疼痛（85.7%），而37.1%有肩部不稳定（主要是前向不稳定）。ABS型是报道中最常见的变异类型。在最初的MRI检查中，60%的病例漏诊了该发现，后来在肩关节镜检查时才被发现。
先天性LHBT缺如可能并不像以前认为的那么罕见。由于现有数据的异质性和低证据水平，很难断定先天性LHBT缺如本身是否是肩部疼痛/撞击或不稳定的原因。
IV级。
