Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A..
Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
Arthroscopy. 2019 Apr;35(4):1036-1041. doi: 10.1016/j.arthro.2018.10.151.
To evaluate outcomes after biceps tenodesis performed in patients younger than 25 years, to evaluate reoperations and complications in this population, and to critically appraise return to preinjury level of play for this population.
Forty-five consecutive patients younger than 25 years underwent subpectoral biceps tenodesis for biceps tendinopathy or biceps-labral complex injuries including SLAP tears. Biceps tenodesis was performed using an interference screw technique. Patients with a minimum 2-year follow-up were analyzed. Functional outcomes were assessed with the visual analog scale score, American Shoulder and Elbow Surgeons (ASES) score, ASES functional score, Simple Shoulder Test score, and range of motion. Activity level and return to sport were followed postoperatively.
Of the 45 patients younger than 25 years who underwent biceps tenodesis, 36 (80%) were available for follow-up at a minimum of 2 years, with a mean age of 19.8 years and mean follow-up period of 38.6 months. Of these 36 patients, 34 (94%) were athletes, with 20 patients playing at collegiate level. All clinical outcome scores improved, with the ASES score improving from 54.7 to 81.7, the ASES functional score improving from 17.5 to 25.1, and the Simple Shoulder Test score improving from 7.4 to 10.1 (P < .001). At the time of follow-up, 4 patients (11%) had undergone revision surgery for other injuries. Of the 34 athletes, 25 (73%) returned to sports, with 19 returning at the same level and 6 returning at a lower level of play; 77% of overhead athletes returned to sports.
When indicated, biceps tenodesis offers an alternative to SLAP repair in young patients. Biceps tenodesis in patients younger than 25 years yields satisfactory outcomes, with two-thirds of patients returning to sport and a low revision rate.
Level IV, therapeutic case series.
评估 25 岁以下患者行肱二头肌肌腱固定术的治疗效果,评估该人群的再手术率和并发症,并批判性地评估该人群恢复到受伤前运动水平的情况。
45 例年龄小于 25 岁的患者因肱二头肌肌腱病变或肱二头肌-盂唇复合体损伤(包括 SLAP 撕裂)行肱二头肌下肌腱固定术。肱二头肌固定术采用骨-腱-骨(BTB)移植物行骨道内交叉螺钉固定技术。对至少随访 2 年的患者进行分析。采用视觉模拟评分(VAS)、美国肩肘外科医师协会(ASES)评分、ASES 功能评分、简易肩测试评分(Simple Shoulder Test score,SST)和活动范围评估功能结果。术后随访活动水平和重返运动情况。
45 例年龄小于 25 岁的患者中行肱二头肌固定术,36 例(80%)至少随访 2 年,平均年龄 19.8 岁,平均随访时间 38.6 个月。36 例患者中,34 例(94%)为运动员,其中 20 例为大学生运动员。所有临床评分均改善,ASES 评分从 54.7 分提高到 81.7 分,ASES 功能评分从 17.5 分提高到 25.1 分,SST 评分从 7.4 分提高到 10.1 分(P <.001)。随访时,4 例(11%)患者因其他损伤行翻修手术。34 例运动员中,25 例(73%)重返运动,19 例回到相同运动水平,6 例回到运动水平较低;77%的过顶运动员重返运动。
在适应证范围内,肱二头肌固定术是年轻患者 SLAP 修复术的一种替代方法。对于 25 岁以下的患者,肱二头肌固定术可获得满意的效果,三分之二的患者可重返运动,且再手术率较低。
IV 级,治疗性病例系列研究。