Hong Chih-Kai, Chang Chih-Hsun, Hsu Kai-Lan, Kuan Fa-Chuan, Wang Ping-Hui, Su Wei-Ren
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
J Orthop Sci. 2020 May;25(3):416-422. doi: 10.1016/j.jos.2019.05.007. Epub 2019 May 31.
55 years of age used to be the cutoff point when deciding between biceps tenotomy and tenodesis for treating biceps tendon pathologies.
Patients aged ≥18 years who had tendonitis in the long head of the biceps and were admitted for arthroscopic surgery were included. A questionnaire with a series of questions assessing patients' current symptoms, their concerns about their outcomes, and personal demographic information was introduced to the participants on the day before the surgery. The patients' preference toward tenotomy and tenodesis was assessed, and χ2 tests and logistic regressions were used to test the association with the categorical and ordinal variables, respectively.
A total of 135 patients enrolled in the study, with 83 males and 52 females, the mean age of which was 56 years (range, 18-75 years). Of all patients, 86 (63.7%) preferred biceps tenodesis as opposed to tenotomy; meanwhile, there was no difference in preference toward tenodesis in each age- and gender-subgroup (range, 55.1% to 71.4%). The different subgroups had specific factors that were predictive of choosing either a tenotomy or tenodesis. In most subgroups, concerns about postoperative arm appearance and the so-called "Popeye" deformity due to tenotomy were factors predictive of choosing biceps tenodesis, whereas concern about longer rehabilitation due to tenodesis was the factor predictive of choosing biceps tenotomy.
Biceps tenodesis is a more preferable choice for patients with biceps tendinopathies in all age and gender subgroups. Patients' concerns on postoperative arm appearance, "Popeye" deformity due to tenotomy, and longer rehabilitation due to tenodesis are the most important predictive factors.
在决定采用肱二头肌肌腱切断术还是肌腱固定术治疗肱二头肌肌腱病变时，55岁曾是一个分界点。
纳入年龄≥18岁、患有肱二头肌长头肌腱炎且因关节镜手术入院的患者。在手术前一天，向参与者发放一份包含一系列问题的问卷，以评估患者当前的症状、对治疗结果的担忧以及个人人口统计学信息。评估患者对肌腱切断术和肌腱固定术的偏好，并分别使用χ2检验和逻辑回归来检验与分类变量和有序变量的相关性。
共有135名患者参与该研究，其中男性83名，女性52名，平均年龄为56岁（范围为18 - 75岁）。在所有患者中，86名（63.7%）更倾向于肱二头肌肌腱固定术而非肌腱切断术；同时，在各个年龄和性别亚组中对肌腱固定术的偏好没有差异（范围为55.1%至71.4%）。不同亚组有特定因素可预测选择肌腱切断术还是肌腱固定术。在大多数亚组中，对术后手臂外观的担忧以及因肌腱切断术导致的所谓“大力水手”畸形是预测选择肱二头肌肌腱固定术的因素，而对因肌腱固定术导致康复时间较长的担忧是预测选择肱二头肌肌腱切断术的因素。
对于所有年龄和性别亚组的肱二头肌肌腱病变患者，肱二头肌肌腱固定术是更优选的选择。患者对术后手臂外观、因肌腱切断术导致的“大力水手”畸形以及因肌腱固定术导致康复时间较长的担忧是最重要的预测因素。
