Riedl Moritz, Mayr Agnes, Greiner Stefan, Pfeifer Christian, Weiss Isabella, Forchhammer Lina, Alt Volker, Kerschbaum Maximilian
Clinic of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
Sporthopaedicum Straubing, Bahnhofplatz 27, 94315 Straubing, Germany.
J Clin Med. 2021 Jan 23;10(3):432. doi: 10.3390/jcm10030432.
(1) Introduction: Several surgical therapy options for the treatment of pathologies of the long biceps tendon (LHB) have been established. However, tenotomy, as well as established tenodesis techniques, has disadvantages, such as cosmetic deformities, functional impairments and residual shoulder pain. This study presents the first clinical and structural results of the recently introduced loop tenodesis procedure for the LHB, developed to overcome these issues. (2) Methods: 37 patients (11 women, 26 men, mean age 52 years), who underwent loop tenodesis of the LHB were examined six months after surgery. For the clinical evaluation the Constant score, as well as the LHB score, were used, complemented by elbow flexion and supination strength measurements. The integrity of the tenodesis construct was evaluated indirectly by sonographic detection of the LHB in the bicipital groove. (3) Results: Both, the overall Constant score as well as the LHB score showed significant improvements six months postoperatively, as compared to the preoperative value. Fourteen patients (38%) presented an examiner-dependent upper arm deformity, although only five patients (13%) reported subjective cosmetic deformities. Both, flexion and supination strength were preserved compared to the preoperative level. In 35 patients (95%), the tenodesis in the bicipital groove was proofed sonographically. (4) Conclusion: The loop tenodesis of the LHB provides good-to-excellent overall clinical results after a short-term follow-up of six month. The incidence of cosmetic deformities was inferior compared to conventional therapy options (tenotomy and anchor tenodesis).
(1) 引言：针对长头肱二头肌（LHB）病变已确立了几种手术治疗方案。然而，肌腱切断术以及已有的肌腱固定术存在一些缺点，如外观畸形、功能障碍和肩部残留疼痛。本研究展示了最近引入的用于LHB的袢式肌腱固定术的首批临床和结构结果，该手术旨在克服这些问题。(2) 方法：对37例行LHB袢式肌腱固定术的患者（11名女性，26名男性，平均年龄52岁）在术后6个月进行检查。临床评估采用Constant评分以及LHB评分，并辅以肘屈曲和旋后力量测量。通过超声检测肱二头肌沟内的LHB间接评估肌腱固定结构的完整性。(3) 结果：与术前值相比，术后6个月总体Constant评分和LHB评分均有显著改善。14例患者（38%）存在检查者依赖的上臂畸形，尽管只有5例患者（13%）报告有主观外观畸形。与术前水平相比，屈曲和旋后力量均得以保留。35例患者（95%）经超声证实肱二头肌沟内的肌腱固定良好。(4) 结论：LHB袢式肌腱固定术在6个月的短期随访后提供了良好至优异的总体临床结果。与传统治疗方案（肌腱切断术和锚定肌腱固定术）相比，外观畸形的发生率较低。
