Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Bone Joint J. 2020 Sep;102-B(9):1194-1199. doi: 10.1302/0301-620X.102B9.BJJ-2020-0076.R1.
The purpose of this study was to identify the changes in untreated long head of the biceps brachii tendon (LHBT) after a rotator cuff tear and to evaluate the factors related to the changes.
A cohort of 162 patients who underwent isolated supraspinatus with the preservation of LHBT was enrolled and evaluated. The cross-sectional area (CSA) of the LHBT on MRI was measured in the bicipital groove, and preoperative to postoperative difference was calculated at least 12 months postoperatively. Second, postoperative changes in the LHBT including intratendinous signal change, rupture, dislocation, or superior labral lesions were evaluated with seeking of factors that were correlated with the changes or newly developed lesions after rotator cuff repair.
The postoperative CSA (12.5 mm (SD 8.3) was significantly larger than preoperative CSA (11.5 mm (SD 7.5); p = 0.005). In total, 32 patients (19.8%) showed morphological changes in the untreated LHBT 24 months after rotator cuff repair. Univariate regression analysis revealed that the factor chiefly related to the change in LHBT status was an eccentric LHBT position within the groove found on preoperative MRI (p = 0.011). Multivariate analysis using logistic regression also revealed that an eccentric LHBT position was a factor related to postoperative change in untreated LHBTs (p = 0.011).
The CSA of the LHBT inside the biceps groove increased after rotator cuff repair. The preoperative presence of an eccentrically positioned LHBT was associated with further changes of the tendon itself after rotator cuff repair. Cite this article: 2020;102-B(9):1194-1199.
本研究旨在确定肩袖撕裂后未经治疗的长头肱二头肌肌腱（LHBT）的变化，并评估与这些变化相关的因素。
本研究纳入并评估了 162 例接受单纯冈上肌修复且保留 LHBT 的患者。在肱二头肌沟内测量 LHBT 的横截面积（CSA），并计算至少术后 12 个月的术前与术后差值。其次，评估术后 LHBT 的变化，包括肌腱内信号变化、断裂、脱位或上盂唇病变，并寻找与肩袖修复后肌腱变化或新发病变相关的因素。
术后 CSA（12.5mm（SD 8.3）明显大于术前 CSA（11.5mm（SD 7.5）；p=0.005）。总共 32 例（19.8%）患者在肩袖修复后 24 个月出现未治疗 LHBT 的形态学变化。单因素回归分析显示，与 LHBT 状态变化主要相关的因素是术前 MRI 显示的沟内 LHBT 偏心位置（p=0.011）。使用逻辑回归的多因素分析也显示，沟内 LHBT 的偏心位置是术后未治疗 LHBT 变化的相关因素（p=0.011）。
肩袖修复后肱二头肌沟内的 LHBT CSA 增加。术前 LHBT 偏心位置与肩袖修复后肌腱本身的进一步变化相关。
