Baumann Quentin, Hue Antoine-Guy, Lutz Patricia Maria, Hardy Alexandre, Mertl Patrice, Courage Olivier
Université Paris Diderot, Bichat Hospital, service d'orthopédie, Paris, France.
Hôpital Privé de l'Estuaire, Ramsay General Health Group, Le Havre, France.
JSES Int. 2020 Jul 11;4(4):906-912. doi: 10.1016/j.jseint.2020.06.005. eCollection 2020 Dec.
Shoulder surgeons performing tenodesis note a great variability in morphology of the proximal biceps. The hourglass biceps test measures the integrity of the intra-articular biceps tendon. The hourglass maneuver (HM) is positive when there is a passive flexion deficit compared to the contralateral shoulder in a relaxed patient in the supine position.
Preoperative HM is correlated with an increased width of the biceps portion resected during tenodesis.
This prospective study evaluated all patients (N = 58) who underwent biceps tenodesis between January and September 2019. Two groups of patients were compared: group 1 (n = 20) had a positive HM and group 2 had a negative HM (n = 38). The smallest (s) and largest (L) width of the tendon were measured intraoperatively, and the L/s ratio was calculated. The HM was then evaluated as a diagnostic test by creating a contingency table and determining the sensitivity and specificity of the test for different L/s ratios. A receiver operating characteristic curve was created and the area under the curve (AUC) was calculated.
A nonsignificant difference was found between the mean largest biceps width in group 1 compared to group 2 (11.65 mm [range: 5-21] vs. 9.71 mm [range: 6-20], respectively; < .05). The AUC was 0.81; the sensitivity was 68.9% and specificity, 80.8%.
Preoperative positivity of the HM is linked to the increased width of the biceps portion resected during tenodesis. The hourglass biceps test should be predictive of intraoperative hourglass biceps according to our definition.
进行肌腱固定术的肩部外科医生注意到肱二头肌近端形态存在很大差异。沙漏型肱二头肌试验用于测量关节内肱二头肌肌腱的完整性。在仰卧位放松的患者中，与对侧肩部相比，若存在被动屈曲缺陷，则沙漏型动作（HM）为阳性。
术前HM与肌腱固定术中切除的肱二头肌部分宽度增加相关。
这项前瞻性研究评估了2019年1月至9月期间接受肱二头肌肌腱固定术的所有患者（N = 58）。比较两组患者：第1组（n = 20）HM为阳性，第2组HM为阴性（n = 38）。术中测量肌腱的最小（s）和最大（L）宽度，并计算L/s比值。然后通过创建列联表并确定该测试对不同L/s比值的敏感性和特异性，将HM评估为一种诊断测试。创建了受试者工作特征曲线并计算了曲线下面积（AUC）。
第1组与第2组肱二头肌最大平均宽度之间未发现显著差异（分别为11.65 mm [范围：5 - 21]和9.71 mm [范围：6 - 20]；P <.05）。AUC为0.81；敏感性为68.9%，特异性为80.8%。
HM术前阳性与肌腱固定术中切除的肱二头肌部分宽度增加有关。根据我们的定义，沙漏型肱二头肌试验应能预测术中的沙漏型肱二头肌情况。
