Kitridis Dimitrios, Yiannakopoulos Christos, Sinopidis Chris, Givissis Panagiotis, Galanis Nikiforos
1st Orthopaedic Department, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
School of Physical Education and Sports Science, National and Kapodistrian University of Athens, 15772 Athens, Greece.
Medicina (Kaunas). 2021 Mar 2;57(3):229. doi: 10.3390/medicina57030229.
Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.
使用阔筋膜自体移植或真皮异体移植进行上盂唇重建（SCR）是治疗不可修复的肩袖（RC）撕裂的既定疗法。最近有人提出肱二头肌长头肌腱（LHBT）可作为SCR的替代移植物。本研究的目的是介绍利用LHBT进行SCR的手术技术和临床研究。检索了截至2020年12月的Medline、Scopus和Cochrane图书馆中的相关研究。主要结果是疼痛强度改善以及RC和LHBT移植物再撕裂的发生率。次要结果是功能评分和肩峰下间隙（AHD）改善情况。九项研究描述了使用LHBT进行SCR的手术技术，四项临床研究报告了该技术的结果。根据视觉模拟量表，平均疼痛强度从4.9±2.3改善至1.6±1.5，超过了充分缓解疼痛的最小临床重要差异。功能评分和AHD也有显著改善。与其他治疗巨大RC撕裂的修复技术，即双排修复、带可吸收补片加强的经骨等效技术以及使用阔筋膜自体移植的传统SCR相比，在疼痛和功能改善方面没有显著差异。使用LHBT进行SCR是治疗巨大RC撕裂的一种有用的治疗选择；它与传统SCR和其他既定技术同样有效。它具有许多优点，是一种安全、简便、省时且经济高效的方法。该技术的唯一前提条件是存在完整的LHBT。需要进行更多的临床试验来确定哪种治疗方法在治疗巨大RC撕裂方面更优，以及评估该技术的长期效果。
