Sasaki Yu, Ochiai Nobuyasu, Kenmoku Tomonori, Yamaguchi Takeshi, Kijima Takehiro, Hashimoto Eiko, Ohtori Seiji
Department of Orthopedic Surgery, Seirei Sakura Citizen Hospital, 2-36-2, Ebaradai, Sakura City, Chiba, 285-8765, Japan.
Department of Orthopedics Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
J Orthop Sci. 2020 May;25(3):410-415. doi: 10.1016/j.jos.2019.05.005. Epub 2019 May 30.
Various arthroscopic tenodesis techniques for the treatment of long head of the biceps tendon pathologic abnormalities have been described.
This study evaluated the clinical outcomes of using a bioabsorbable interference screw and soft anchor for long head of the biceps tendon arthroscopic tenodesis.
Sixty patients treated by this technique between February 2013 and March 2015 were followed up for at least 2 years. In our operative technique, after the bone hole was made just proximal to the pectoralis major, the soft anchor was inserted at the bottom of the hole. After tenotomy of the long head of the biceps tendon proximal to the bone hole, the tendon was fixed into the bottom of the hole temporarily using the soft anchor. Finally, the tendon was fixed in the hole with a bioabsorbable interference screw.
The UCLA score 15.1 points preoperatively and 32.4 points at follow-up (p < 0.05). The Constant 55.8 points preoperatively and 93.9 points at follow-up (p < 0.01). After biceps tenodesis, no cosmetic deformities were found in 56 patients (93.3%), and four patients (6.7%) had a Popeye deformity. On postoperative magnetic resonance evaluation, the long head of the biceps tendon was located on the bicipital groove without deviation in 53 cases (88.3%), on the bicipital groove with a partial deviation in 6 cases (10.0%), and outside the bicipital groove with complete deviation (dislocated) in 1 case (1.7%).
We found that arthroscopic biceps tenodesis using a soft anchor provided a reliable means for treating biceps pathology with no cosmetic deformities and with good clinical results.
已描述了多种用于治疗肱二头肌长头肌腱病理异常的关节镜下腱固定技术。
本研究评估使用生物可吸收加压螺钉和软锚钉进行肱二头肌长头肌腱关节镜下腱固定的临床效果。
对2013年2月至2015年3月间采用该技术治疗的60例患者进行至少2年的随访。在我们的手术技术中,在胸大肌近端制作骨孔后,将软锚钉插入孔底。在骨孔近端切断肱二头肌长头肌腱后,使用软锚钉将肌腱暂时固定在孔底。最后,用生物可吸收加压螺钉将肌腱固定在孔内。
术前UCLA评分为15.1分,随访时为32.4分(p < 0.05)。术前Constant评分为55.8分,随访时为93.9分(p < 0.01)。肱二头肌腱固定术后,56例患者(93.3%)未发现外观畸形,4例患者(6.7%)出现“大力水手”畸形。术后磁共振评估显示,肱二头肌长头肌腱位于肱二头肌沟内无移位53例(88.3%),位于肱二头肌沟内有部分移位6例(10.0%),位于肱二头肌沟外完全移位(脱位)1例(1.7%)。
我们发现使用软锚钉的关节镜下肱二头肌腱固定为治疗肱二头肌病变提供了一种可靠的方法,无外观畸形且临床效果良好。