Faict Sebastian, Van de Meulebroucke Bart, Van Royen Kjell, Bleys Dries, Rezaie Wahid, Middernacht Bart
Department of Orthopaedics and Traumatology, OLV Aalst, Moorselbaan 164, 9300, Aalst, Belgium.
Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium.
Eur J Orthop Surg Traumatol. 2019 Oct;29(7):1405-1409. doi: 10.1007/s00590-019-02470-y. Epub 2019 Jun 17.
Surgical reinsertion of the distal biceps tendon for acute and chronic tears is a widely accepted procedure, but little is known about surgical treatment of distal biceps tendinopathy.
Twenty patients underwent a surgical procedure for distal biceps tendinopathy after failure of conservative treatment. The surgery was performed through a single incision. The biceps tendon was detached, debrided and reinserted using a ToggleLoc (Zimmer Biomet) device. Clinical and radiologic evaluation was performed after a minimum follow-up of 1 year. Quick-Dash score, Liverpool Elbow Score, Mayo Elbow Performance Index, Broberg and Morrey Score and Short HSS Scoring System were used, and isokinetic testing was performed.
The outcome of these five clinical elbow scores showed no clinically relevant differences between the affected and non-affected side. Isokinetic testing of peak torque in flexion and supination showed equal strength between both sides. These results indicate good functional outcome and recovery of flexion and supination, compared to the non-operated side and the normal population.
This study demonstrates that distal biceps tendon debridement and reinsertion is a safe and valid option for patients with distal biceps tendinopathy after failure of conservative treatment.
Level 3 retrospective cohort study.
对于急性和慢性肱二头肌远端肌腱撕裂,手术重新植入是一种广泛接受的手术方法,但对于肱二头肌远端肌腱病的手术治疗知之甚少。
20例患者在保守治疗失败后接受了肱二头肌远端肌腱病的手术治疗。手术通过单一切口进行。使用ToggleLoc(捷迈邦美)装置将肱二头肌肌腱分离、清创并重新植入。在至少随访1年后进行临床和影像学评估。使用Quick-Dash评分、利物浦肘关节评分、梅奥肘关节功能指数、布罗伯格和莫里评分以及短HSS评分系统,并进行等速测试。
这五项临床肘关节评分的结果显示,患侧和未患侧之间在临床上没有显著差异。屈曲和旋后峰值扭矩的等速测试显示两侧力量相等。与未手术侧和正常人群相比,这些结果表明功能结局良好,屈曲和旋后功能得以恢复。
本研究表明,对于保守治疗失败的肱二头肌远端肌腱病患者,肱二头肌远端肌腱清创和重新植入是一种安全有效的选择。
3级回顾性队列研究。