Candela Vittorio, Preziosi Standoli Jacopo, Carbone Stefano, Rionero Marco, Gumina Stefano
Department of Anatomical, Histological, Forensic Medicine and Orthopaedics Sciences, Sapienza University of Rome, Rome, Italy.
Istituto Clinico Ortopedico Traumatologico, Latina, Italy.
Arthrosc Sports Med Rehabil. 2021 Aug 27;3(5):e1517-e1523. doi: 10.1016/j.asmr.2021.07.013. eCollection 2021 Oct.
To evaluate the association between rotator cuff tear (RCT) size and long head biceps tendon (LHBT) pathology.
We retrospectively enrolled 202 consecutive patients (114 women and 88 men with mean age at surgery of 62.14 years [SD, 7.73]) who underwent arthroscopic rotator cuff repair for different sized full-thickness RCTs. LHBT pathology was evaluated considering the presence of inflammation, section alteration, loss of integrity, dislocation, dynamic instability, and absence. The site of LHBT pathology was evaluated considering 3 portions: (1) the insertional element; (2) the free intra-articular portion; (3) the part that enters the intertubercular groove. Statistics were evluated.
The LHBT was absent in 22 cases (10.9%): 2, 4, 15, and 1 patients with small, large, massive, and subscapularis RCTs, respectively. A significant correlation was found between the prevalence of LHBT absence and massive RCTs ( < .001). In 53 patients (26%), there was a healthy LHBT; a healthy LHBT was present in 47%, 20% and 8% of small, large and massive RCTs, respectively. A significant correlation between LHBT inflammation, section alteration, loss of integrity, and RCT severity was found ( < .001, < .001, and ). The insertional portion was the most involved (57% of cases); RCT severity was significantly associated with the number of involved portions ( < .001).
Shoulder LHBT pathology is associated with increasing rotator cuff tear size.
Surgeons should be aware that biceps pathology is particularly prevalent in patients with larger RTCs.
评估肩袖撕裂（RCT）大小与肱二头肌长头肌腱（LHBT）病变之间的关联。
我们回顾性纳入了202例连续患者（114例女性和88例男性，手术时平均年龄为62.14岁[标准差，7.73]），这些患者因不同大小的全层RCT接受了关节镜下肩袖修复术。考虑到炎症、断面改变、完整性丧失、脱位、动态不稳定和缺失情况，对LHBT病变进行评估。将LHBT病变部位分为三个部分进行评估：（1）插入部分；（2）关节内游离部分；（3）进入结节间沟的部分。进行了统计学评估。
22例（10.9%）患者的LHBT缺失：小、大、巨大和肩胛下肌RCT患者中分别有2例、4例、15例和1例。发现LHBT缺失的患病率与巨大RCT之间存在显著相关性（P<0.001）。53例患者（26%）的LHBT正常；小、大、巨大RCT患者中LHBT正常的比例分别为47%、20%和8%。发现LHBT炎症、断面改变、完整性丧失与RCT严重程度之间存在显著相关性（P<0.001、P<0.001和P<0.001）。插入部分受累最多（57%的病例）；RCT严重程度与受累部分的数量显著相关（P<0.001）。
肩部LHBT病变与肩袖撕裂大小增加有关。
外科医生应意识到，肱二头肌病变在较大RTC患者中尤为普遍。
