Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC, USA; OrthoCarolina Research Institute, Charlotte, NC, USA; OrthoCarolina Sports Medicine Center, Charlotte, NC, USA.
Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, NC, USA; OrthoCarolina Research Institute, Charlotte, NC, USA; OrthoCarolina Sports Medicine Center, Charlotte, NC, USA.
J Shoulder Elbow Surg. 2018 Jul;27(7):1258-1262. doi: 10.1016/j.jse.2018.01.006. Epub 2018 Feb 22.
The prevalence and severity of concomitant rotator cuff pathology in the setting of proximal biceps tendon ruptures are poorly understood. Concomitant rotator cuff disease may have important implications in the prognosis and natural history of this shoulder condition. Therefore, an observational cohort of patients with an acute rupture of the long head of the biceps tendon (LHBT) was evaluated to determine the prevalence and severity of concomitant rotator cuff disease.
Thirty consecutive patients diagnosed with acute proximal biceps tendon rupture were prospectively enrolled. Magnetic resonance imaging of the affected shoulder was obtained in 27 patients and reviewed by a fellowship-trained orthopedic surgeon.
The cohort consisted of 20 men (74%) and 7 women (26%) (mean age, 61.0 years [range, 42-78 years]). The dominant side was involved in 20 injuries (74%), and a low-energy trauma mechanism of injury was involved in 23 (85%). Of the patients, 11 (41%) reported a history of antecedent shoulder pain. Magnetic resonance imaging assessment revealed that 93% of patients had evidence of rotator cuff disease, including 13 full-thickness tears. Of the full-thickness tears, 3 were small, 6 medium, 2 large, and 2 massive. Pathology of the subscapularis tendon was identified in 7 patients (26%).
In this cohort, we found LHBT rupture to be highly correlated with the presence of rotator cuff disease, with the majority of patients presenting with full-thickness tears of the supraspinatus. These findings may have important implications in the treatment and prognosis of patients who present with acute LHBT ruptures.
在肱二头肌长头肌腱断裂的情况下，同时存在肩袖病变的患病率和严重程度了解甚少。同时存在肩袖疾病可能对这种肩部疾病的预后和自然病史有重要影响。因此，评估了一组急性肱二头肌长头肌腱（LHBT）断裂的患者，以确定同时存在肩袖疾病的患病率和严重程度。
前瞻性纳入了 30 例确诊为急性肱二头肌长头肌腱近端断裂的患者。对 27 例患者进行了受累肩部的磁共振成像检查，并由一位经过 fellowship培训的骨科医生进行了评估。
该队列包括 20 名男性（74%）和 7 名女性（26%）（平均年龄 61.0 岁[范围，42-78 岁]）。优势侧受累 20 处损伤（74%），低能量创伤机制导致损伤 23 处（85%）。11 例（41%）患者报告有先前肩部疼痛史。磁共振成像评估显示，93%的患者存在肩袖疾病证据，包括 13 例全层撕裂。全层撕裂中，3 例为小撕裂，6 例为中等撕裂，2 例为大撕裂，2 例为巨大撕裂。7 例（26%）患者存在肩胛下肌腱病变。
在本队列中，我们发现 LHBT 断裂与肩袖疾病高度相关，大多数患者存在冈上肌全层撕裂。这些发现可能对急性 LHBT 断裂患者的治疗和预后有重要影响。
