Milenin Oleg, Sergienko Ruslan, Razumov Aleksandr
National Medical Surgical Center, Moscow, Russia.
Medical Center of Modern Orthopedics Kiev, Ukraine.
Arthrosc Tech. 2020 Dec 19;10(1):e1-e7. doi: 10.1016/j.eats.2020.08.038. eCollection 2021 Jan.
Biceps tenodesis is a common treatment method for biceps pathology. When tenodesis is located in intra-articular or suprapectoral areas, the biceps is fixed proximally to the zone of degeneration and inflammation, which can cause residual pain as a possible postsurgical complication. The main advantage of this method is that this technique is comparatively easy and can be performed arthroscopically. Typically, in terms of professional athletes, the best post-biceps tenodesis results are observed after undergoing subpectoral tenodesis because of the solid fixation and localization distally to any kind of biceps tendon degeneration and inflammation zone. However, subpectoral tenodesis has several disadvantages, as it is an open procedure that can lead to possible scar and hematoma formation, infection, bioabsorbable screw reaction, neurovascular injury, and fractures. Soft-tissue tenodesis to the proximal part of pectoralis major tendon is a well-known step in shoulder arthroplasty surgery and shows acceptable results. We suggest a technique of proximal subpectoral arthroscopic tenodesis, which combines the advantages of the location in the subpectoral zone with an all-suture anchor and that of soft-tissue tenodesis to the pectoralis major tendon, which can be performed fully arthroscopically, improving results in terms of healing by increasing the contact area.
肱二头肌固定术是治疗肱二头肌病变的常用方法。当固定术位于关节内或胸肌上区域时，肱二头肌在近端固定于退变和炎症区域，这可能导致残留疼痛，成为一种可能的术后并发症。该方法的主要优点是操作相对简单，可通过关节镜进行。通常，对于职业运动员来说，胸肌下固定术后观察到的肱二头肌固定术效果最佳，因为其固定牢固且位于肱二头肌肌腱任何退变和炎症区域的远端。然而，胸肌下固定术有几个缺点，因为它是一种开放手术，可能导致瘢痕和血肿形成、感染、生物可吸收螺钉反应、神经血管损伤和骨折。将软组织固定于胸大肌肌腱近端是肩关节置换手术中一个众所周知的步骤，且效果尚可。我们提出一种近端胸肌下关节镜固定技术，该技术结合了胸肌下区域定位的优点、全缝线锚钉的优点以及软组织固定于胸大肌肌腱的优点，可完全通过关节镜进行，通过增加接触面积提高愈合效果。
