Ergün Selim, Cırdı Yiğit Umur, Baykan Said Erkam, Akgün Umut, Karahan Mustafa
Department of Orthopaedics and Traumatology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey.
Department of Orthopaedics and Traumatology, Yüksekova State Hospital, Hakkari, Turkey.
Shoulder Elbow. 2022 Feb;14(1):6-15. doi: 10.1177/1758573221989089. Epub 2021 Feb 9.
Simultaneous repairs of rotator cuff and biceps tenodesis can be managed by tenodesis of long head of biceps tendon to a subpectoral or suprapectoral area. This review investigated long head of biceps tendon tenodesis with concomitant rotator cuff repair and evaluated the clinical outcomes and incidences of complications based on tenodesis location.
Medline, Cochrane, and Embase databases were searched for published, randomized or nonrandomized controlled studies and prospective or retrospective case series with the phrases "suprapectoral," "subpectoral," "tenodesis," and "long head of biceps tendon". Those with a clinical evidence Level IV or higher were included. Non-English manuscripts, review articles, commentaries, letters, case reports, and sole long head of biceps tendon tenodesis articles were excluded.
From 481 studies, 13 were chosen. In total, 1194 subpectoral and 2520 suprapectoral tenodesis cases were investigated. Postoperative Constant-Murley and American Shoulder and Elbow Surgeons mean scores showed similar good results. In terms of complication incidences, while transient nerve injuries were more commonly seen in patients with subpectoral tenodesis, persistent bicipital pain and Popeye deformity are mostly seen in patients with suprapectoral tenodesis.
Biceps tenodesis to suprapectoral or subpectoral area with concomitant rotator cuff repair demonstrated similar outcomes. Popeye deformity and persistent bicipital pain were higher in suprapectoral area and transient neuropraxia was found to be higher in subpectoral area.: IV.
肩袖修复与肱二头肌固定术同时进行时，可通过将肱二头肌长头肌腱固定于胸小肌下或胸小肌上区域来完成。本综述研究了肱二头肌长头肌腱固定术联合肩袖修复术，并根据固定位置评估了临床疗效和并发症发生率。
在Medline、Cochrane和Embase数据库中检索已发表的随机或非随机对照研究以及前瞻性或回顾性病例系列，检索词为“胸小肌上”“胸小肌下”“固定术”和“肱二头肌长头肌腱”。纳入临床证据等级为IV级或更高的研究。排除非英文手稿、综述文章、评论、信函、病例报告以及单纯的肱二头肌长头肌腱固定术文章。
从481项研究中筛选出13项。共调查了1194例胸小肌下固定术和2520例胸小肌上固定术病例。术后Constant-Murley评分和美国肩肘外科医师协会平均评分显示出相似的良好结果。在并发症发生率方面，虽然胸小肌下固定术患者更常出现短暂性神经损伤，但胸小肌上固定术患者更常出现持续性肱二头肌疼痛和“大力水手”畸形。
肱二头肌在胸小肌上或胸小肌下区域固定联合肩袖修复术显示出相似的结果。“大力水手”畸形和持续性肱二头肌疼痛在胸小肌上区域更高，而短暂性神经失用症在胸小肌下区域更高。证据等级：IV级。
