Lacheta Lucca, Imhoff Andreas B, Siebenlist Sebastian, Scheiderer Bastian
Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
Arthrosc Tech. 2020 Apr 25;9(5):e651-e655. doi: 10.1016/j.eats.2020.01.019. eCollection 2020 May.
Surgical management for biceps pathologies has advanced to provide stronger fixation and to be less invasive. The long head of the biceps tendon has been recognized as a common contributor to anterior shoulder pain and is often associated with other glenohumeral pathologies such as SLAP lesions, rotator cuff tears, and subacromial impingement. Both tenotomy and tenodesis have shown to be effective in ameliorating pain associated with the long head of the biceps tendon. However, decreased muscle function and cosmetic concerns are seen at higher rates after tenotomy compared with tenodesis. One option for the treatment of biceps tendon pathology includes mini-open subpectoral biceps tenodesis. Lower reoperation rates are observed after subpectoral biceps tenodesis than after suprapectoral biceps tenodesis, with thoughts that releasing the tendon from its sheath and the bicipital groove relieves the patient of most associated pain. The purpose of this Technical Note is to describe in detail our preferred operative technique for mini-open subpectoral biceps tenodesis using an onlay technique with all-suture anchor fixation.
针对肱二头肌病变的手术治疗已取得进展，能够提供更牢固的固定且侵入性更小。肱二头肌长头已被认为是导致肩部前方疼痛的常见原因，并且常与其他盂肱关节病变相关，如SLAP损伤、肩袖撕裂和肩峰下撞击症。肌腱切断术和肌腱固定术在改善与肱二头肌长头相关的疼痛方面均已显示出效果。然而，与肌腱固定术相比，肌腱切断术后肌肉功能下降和美观问题的发生率更高。治疗肱二头肌肌腱病变的一种选择包括小切口胸大肌下肱二头肌肌腱固定术。胸大肌下肱二头肌肌腱固定术后的再次手术率低于胸大肌上肱二头肌肌腱固定术，原因是认为将肌腱从腱鞘和肱二头肌沟中松解可减轻患者的大部分相关疼痛。本技术说明的目的是详细描述我们使用全缝线锚钉固定的覆盖技术进行小切口胸大肌下肱二头肌肌腱固定术的首选手术技术。
