Department of Diagnostic and Interventional Radiology, University of Insubria, Varese, Italy.
Department of Radiology ASST Valle Olona, Busto Arsizio Hospital, Busto Arsizio, Italy.
J Orthop Traumatol. 2022 Mar 8;23(1):13. doi: 10.1186/s10195-022-00631-0.
The purpose of this work is to characterize the anatomy of the intraarticular portion of the long head of the biceps tendon (long head biceps tendon) using magnetic resonance (MR) arthrography by investigating whether anatomical variants may facilitate the onset of a supraequatorial lesion (superior labral anterior to posterior, SLAP).
In 482 shoulder MR arthrographies, we considered the anatomical variants of the intraarticular portion of the long head of the biceps tendon classified according to Dierickx's arthroscopic classification; lesions of supraequatorial structures were considered in the data analysis. For each anatomical variant, correlation with SLAP and the odd ratio were statistically evaluated, using Fisher's exact (or chi-squared) test and logistic regression analysis, respectively.
In the mesotenon-type variant, the SLAP frequency was higher than expected [χ (df = 4) = 14.9, p = 0.005] with a higher risk of developing a type I SLAP (p = 0.0003). In the adherent-type variant, the type II SLAP frequency was higher than expected [χ (df = 3) = 18.1, p = 0.0004] with a higher risk of developing type II SLAP (p = 0.0001). Two cases of "split" (SPL) long head biceps tendon had III and type IV SLAP, respectively. These patients have a higher risk for type IV SLAP [odds ratio (OR) 19.562, 95% confidence interval (CI) 1.604-238.541, p = 0.001]. An increased risk of developing SLAP type II was calculated for male subjects (OR 3.479, 95% CI 1.013-11.951, p = 0.019).
It is possible that adherence of the long head biceps tendon to the supraspinatus more often predisposes to a lesion of the superior glenoid labrum (SLAP), in view of the close relationships between the fibrocartilage and the bicipital anchor, probably related to the limited excursion of the intraarticular long head biceps tendon.
本研究旨在通过磁共振（MR）关节造影术研究肱二头肌长头肌腱（长头二头肌肌腱）关节内部分的解剖结构，探讨解剖变异是否有助于赤道以上病变（上盂唇前-后，SLAP）的发生。
在 482 例肩关节 MR 关节造影中，我们根据 Dierickx 的关节镜分类，对长头二头肌肌腱关节内部分的解剖变异进行分类；在数据分析中考虑了赤道以上结构的病变。对于每种解剖变异，使用 Fisher 确切（或卡方）检验和逻辑回归分析分别进行统计学评估与 SLAP 的相关性和比值比。
在中腱型变异中，SLAP 发生率高于预期[χ（df=4）=14.9，p=0.005]，发生 I 型 SLAP 的风险更高（p=0.0003）。在黏附型变异中，II 型 SLAP 的发生率高于预期[χ（df=3）=18.1，p=0.0004]，发生 II 型 SLAP 的风险更高（p=0.0001）。2 例“分裂”（SPL）长头二头肌肌腱分别有 III 型和 IV 型 SLAP。这些患者发生 IV 型 SLAP 的风险更高[比值比（OR）19.562，95%置信区间（CI）1.604-238.541，p=0.001]。男性发生 SLAP II 型的风险增加（OR 3.479，95%CI 1.013-11.951，p=0.019）。
鉴于纤维软骨和二头肌附着之间的密切关系，长头二头肌肌腱附着于冈上肌腱更容易导致上盂唇病变（SLAP），这可能与关节内长头二头肌肌腱的活动度有限有关。
