Carthage Area Hospital, Carthage, New York, USA.
Claxton-Hepburn Medical Center, Ogdensburg, New York, USA.
Am J Sports Med. 2021 Dec;49(14):3945-3951. doi: 10.1177/03635465211049373. Epub 2021 Oct 21.
Biceps tenodesis has been suggested as a superior surgical technique compared with isolated labral repair for superior labral anterior-posterior (SLAP) tears in patients older than 35 years. The superiority of this procedure in younger patients, however, is yet to be determined.
To compare the outcomes of arthroscopic SLAP repair with those of arthroscopic-assisted subpectoral biceps tenodesis for type II SLAP tears in active-duty military patients younger than 35 years.
Cohort study; Level of evidence, 3.
Preoperative and postoperative evaluations with a minimum 5-year follow-up including the visual analog scale (VAS), the Single Assessment Numeric Evaluation (SANE), and the American Shoulder and Elbow Surgeons (ASES) shoulder score were administered, and scores were compared between 2 groups of patients younger than 35 years. One group included 25 patients who underwent SLAP repair, and the second group included 23 patients who underwent arthroscopic-assisted subpectoral biceps tenodesis.
The preoperative patient age ( = .3639), forward flexion ( = .8214), external rotation ( = .5134), VAS pain score ( = .4487), SANE score ( = .6614), and ASES score ( = .6519) did not vary significantly between the 2 study groups. Both groups demonstrated statistically significant increases in function as measured by the ASES and SANE and decreases in pain as measured by the VAS at a minimum of 5 years postoperatively. Also at a minimum of 5 years postoperatively, patients in the tenodesis group had lower pain (1.3 vs 2.6, respectively; = .0358) and higher SANE (84.0 vs 63.3, respectively; = .0001) and ASES (85.7 vs 75.4, respectively; = .0342) scores compared with those in the repair group. Failure rate was 20.0% in the repair group versus 0.0% in the tenodesis group ( = .0234).
Active-duty military patients younger than 35 years with type II SLAP tears had more predictable improvement in pain, better functional outcomes, and lower failure rates after biceps tenodesis compared with SLAP repair for type II SLAP tears. Overall, the results of this study indicate that arthroscopic- assisted subpectoral biceps tenodesis is superior to arthroscopic SLAP repair for the treatment of type II SLAP tears in military patients younger than 35 years.
对于 35 岁以上的患者，与单纯盂唇修复相比，肱二头肌肌腱固定术被认为是一种更优的手术技术，用于治疗上盂唇前后向（SLAP）撕裂。然而，这种手术在年轻患者中的优势尚待确定。
比较关节镜下 SLAP 修复与关节镜辅助下肩胛下肌肌腱固定术治疗 35 岁以下现役军人Ⅱ型 SLAP 撕裂的疗效。
队列研究；证据等级，3 级。
对 2 组年龄小于 35 岁的患者进行术前和术后至少 5 年的随访评估，包括视觉模拟评分（VAS）、单一评估数字评估（SANE）和美国肩肘外科医生（ASES）肩部评分，并比较 2 组患者的评分。一组包括 25 例接受 SLAP 修复的患者，另一组包括 23 例接受关节镜辅助下肩胛下肌肌腱固定术的患者。
2 组患者的术前年龄（ =.3639）、前屈（ =.8214）、外旋（ =.5134）、VAS 疼痛评分（ =.4487）、SANE 评分（ =.6614）和 ASES 评分（ =.6519）差异无统计学意义。2 组患者在术后至少 5 年时的 ASES 和 SANE 功能评分均显著增加，VAS 疼痛评分均显著降低。术后至少 5 年时，肌腱固定组患者的疼痛评分更低（分别为 1.3 和 2.6， =.0358），SANE 评分（分别为 84.0 和 63.3， =.0001）和 ASES 评分（分别为 85.7 和 75.4， =.0342）更高，而修复组患者的疼痛评分更高（分别为 2.6 和 1.3， =.0358），SANE 评分（分别为 63.3 和 84.0， =.0001）和 ASES 评分（分别为 75.4 和 85.7， =.0342）更低。修复组的失败率为 20.0%，肌腱固定组为 0.0%（ =.0234）。
与 SLAP 修复相比，对于 35 岁以下的Ⅱ型 SLAP 撕裂患者，肱二头肌肌腱固定术可更显著地改善疼痛，提高功能结局，降低失败率。总体而言，这项研究的结果表明，对于 35 岁以下的现役军人，与关节镜下 SLAP 修复相比，关节镜辅助下肩胛下肌肌腱固定术治疗Ⅱ型 SLAP 撕裂更具优势。
