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慢性撕裂伤采用同种异体移植物进行肱二头肌远端重建后,恢复峰值力量和耐力。

Restoration of peak strength and endurance following distal biceps reconstruction with allograft for chronic ruptures.

机构信息

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.

出版信息

J Shoulder Elbow Surg. 2020 Apr;29(4):853-858. doi: 10.1016/j.jse.2019.12.016.

Abstract

BACKGROUND

Distal biceps reconstruction for chronic rupture often requires a graft to recover length and allow for distal tendon reattachment to bone. Our purpose was to assess peak strength and endurance recovery following biceps reconstruction with tendon grafts.

HYPOTHESIS

We hypothesized that allograft reconstruction would result in decreased flexion and supination peak strength and endurance.

METHODS

Consecutive distal biceps reconstructions with allograft, performed for chronic ruptures between January 2008 and March 2018 at a single institution, were reviewed. Isokinetic dynamometry for peak strength and endurance testing was performed on the operative and contralateral arms in flexion and supination. Functional outcomes and overall satisfaction with the operation were determined.

RESULTS

Eleven patients were available for a complete evaluation, including dynamometry, at a mean of 46 months postoperatively. Reconstructions demonstrated a nonsignificant trend toward decreased peak flexion strength (P = .06), and significantly decreased peak supination strength (P = .01) compared with the unaffected arm. There were no differences in flexion and supination endurance between the affected and unaffected arms. Using standardized outcome scales, patients reported excellent function.

CONCLUSION

Chronic biceps ruptures undergoing reconstruction are highly functional and patients are satisfied. Somewhat surprisingly, supination and flexion endurance were equal to the contralateral, uninvolved arm. However, this procedure does not restore peak supination strength.

摘要

背景

慢性肱二头肌撕裂常需要移植物来恢复长度,并使远端肌腱重新附着于骨。我们的目的是评估肱二头肌重建后移植物重建的峰值力量和耐力恢复情况。

假设

我们假设同种异体重建会导致屈肌和旋后峰值力量和耐力下降。

方法

回顾 2008 年 1 月至 2018 年 3 月在一家单中心进行的慢性撕裂的同种异体肱二头肌重建。在手术和对侧手臂上进行等速测功仪的峰值力量和耐力测试,用于屈肌和旋后。对手术的功能结果和总体满意度进行了评估。

结果

11 例患者术后平均 46 个月可进行完整的评估,包括测功仪。与未受伤的手臂相比,重建后的屈肌峰值力量有降低的趋势(P =.06),而旋后峰值力量显著降低(P =.01)。患侧与未受伤手臂的屈肌和旋后耐力无差异。使用标准化的结果量表,患者报告了良好的功能。

结论

接受重建的慢性肱二头肌撕裂功能高度正常,患者满意度高。令人惊讶的是,旋后和屈肌耐力与对侧未受伤的手臂相当。然而,该手术并不能恢复旋后峰值力量。

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