Angelo Richard L
ProOrtho Clinic, Kirkland, Washington.
Sports Med Arthrosc Rev. 2018 Dec;26(4):176-180. doi: 10.1097/JSA.0000000000000197.
Disorders of the long head of the biceps tendon can make a significant contribution to shoulder pain and dysfunction. Historically, open biceps tenotomy or a proximal tenodesis of the tendon through a deltopectoral approach was used to manage biceps tendonitis and instability. Recent developments have added additional options. Arthroscopic techniques offer minimally invasive methods to secure the biceps in the suprapectoral region at the appropriate length. An open subpectoral tenodesis provides for simple exposure that secures the tendon just proximal to the musculotendinous junction and eliminates potentially diseased tendon and synovium from the biceps groove. Common fixation methods include the use of interference screws, suture anchors, and button devices. Future developments will likely add modified tenotomy techniques that will minimize the Popeye deformity in low-demand individuals. Simpler, but secure methods of fixation for higher demand patients will minimize the operative time required.
肱二头肌长头腱疾病可对肩部疼痛和功能障碍产生重大影响。历史上，开放肱二头肌肌腱切断术或经三角肌胸大肌入路对肌腱进行近端固定术曾用于治疗肱二头肌肌腱炎和不稳定。最近的进展增加了更多选择。关节镜技术提供了微创方法，可在胸大肌上方区域以适当长度固定肱二头肌。开放胸大肌下固定术可提供简单的暴露，将肌腱固定在肌腱肌肉交界处近端，消除肱二头肌沟内潜在病变的肌腱和滑膜。常见的固定方法包括使用干涉螺钉、缝合锚钉和纽扣装置。未来的进展可能会增加改良的肌腱切断术技术，以尽量减少低需求个体的肱二头肌畸形。对于高需求患者，更简单但可靠的固定方法将减少所需的手术时间。
