Department of Orthopaedic Surgery, Northwestern University, Lavin Family Pavilion, 259 E. Erie St. 13th Fl., Chicago, IL, 60611, USA.
Department of Orthopaedic Surgery, William Beaumont Hospital, 3535 West 13 Mile Road, Suite 744, Royal Oak, MI, 48073, USA.
Knee Surg Sports Traumatol Arthrosc. 2021 Jan;29(1):257-265. doi: 10.1007/s00167-020-05971-0. Epub 2020 Apr 6.
Compared to a relatively older population over 30-40 years of age, the efficacy of biceps tenodesis for type II SLAP lesions in a younger population is not well studied. The purpose of this study was to compare outcomes between biceps tenodesis and labral repair for type II SLAP lesions in a young active population.
Patients aged 15-40 who underwent primary arthroscopic biceps tenodesis or SLAP repair for type II SLAP tears between 2009 and 2016 were included. Shoulders with intraarticular chondral damage, full thickness rotator cuff tear, rotator cuff repair, labral repair outside of the superior labrum, bony subacromial decompression, and acromioclavicular joint resection were excluded. Patient-reported outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand Sports/Performing Arts Module (DASH-sport), visual analog scale (VAS) for pain, and satisfaction. Return to sport rates were also recorded.
Fifty-three patients (20 tenodesis, 33 repair) were available for minimum 2-year follow-up. Postoperatively, there were no significant differences in mean ASES, DASH-sport, VAS, and satisfaction between groups [ASES: tenodesis 86.3 vs. repair 86.4 (n.s.); DASH-sport: 11.0 vs. 22.5 (n.s.); VAS: 1.85 vs. 1.64 (n.s.); satisfaction: 8.50 vs. 8.00 (n.s.)]. Rate of return to pre-injury level of performance/competition in sport/physical activity was also similar between groups [tenodesis 63% vs. repair 50% (n.s.)].
In a young active population, primary arthroscopic biceps tenodesis is a viable surgical alternative to labral repair for type II SLAP lesions. The results of this study suggest that indications for arthroscopic tenodesis can safely be expanded to a younger patient group than has previously been demonstrated in the literature.
III.
与 30-40 岁以上的相对较年长人群相比，对于年轻人群中的 II 型 SLAP 病变，肱二头肌肌腱固定术的疗效尚未得到充分研究。本研究的目的是比较年轻活跃人群中 II 型 SLAP 病变的肱二头肌肌腱固定术与盂唇修复术的结果。
纳入 2009 年至 2016 年间接受初次关节镜下肱二头肌肌腱固定术或 SLAP 修复术治疗 II 型 SLAP 撕裂的年龄在 15-40 岁的患者。排除关节内软骨损伤、全层肩袖撕裂、肩袖修复、盂唇在盂上唇之外修复、骨肩峰下减压和肩锁关节切除的患者。使用美国肩肘外科医生（ASES）评分、手臂、肩部和手残疾（DASH）运动/表演艺术模块、疼痛视觉模拟量表（VAS）和满意度评估患者报告的结果。还记录了重返运动的比率。
53 例患者（20 例肌腱固定术，33 例修复术）获得了至少 2 年的随访。术后两组间平均 ASES、DASH 运动、VAS 和满意度均无显著差异[ASES：肌腱固定术 86.3 比修复术 86.4（无统计学意义）；DASH 运动：11.0 比 22.5（无统计学意义）；VAS：1.85 比 1.64（无统计学意义）；满意度：8.50 比 8.00（无统计学意义）]。两组重返术前运动/体育活动水平的比率也相似[肌腱固定术 63%比修复术 50%（无统计学意义）]。
在年轻活跃人群中，对于 II 型 SLAP 病变，初次关节镜下肱二头肌肌腱固定术是盂唇修复术的可行手术替代方法。本研究结果表明，与文献中先前显示的相比，关节镜下肌腱固定术的适应证可以安全地扩展到年轻患者群体。
III 级。
