Lacheta Lucca, Horan Marilee P, Nolte Philip C, Goldenberg Brandon T, Dekker Travis J, Millett Peter J
Steadman Philippon Research Institute, Vail, Colorado, USA.
Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
Orthop J Sports Med. 2022 Jun 21;10(6):23259671221105239. doi: 10.1177/23259671221105239. eCollection 2022 Jun.
It remains unclear if young overhead athletes with isolated superior labrum anterior-posterior (SLAP) type 2 lesions benefit more from SLAP repair or subpectoral biceps tenodesis.
To evaluate clinical outcomes and return to sport in overhead athletes with symptomatic SLAP type 2 lesions who underwent either biceps tenodesis or SLAP repair.
Cohort study; Level of evidence, 3.
A retrospective analysis of prospectively collected data was performed in patients who underwent subpectoral biceps tenodesis (n = 14) or SLAP repair (n = 24) for the treatment of isolated type 2 SLAP lesions. All patients were aged <35 years at time of surgery, participated in overhead sports, and were at least 2 years out from surgery. Clinical outcomes were assessed with the American Shoulder and Elbow Surgeons (ASES) score; Single Assessment Numerical Evaluation (SANE) score; Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score; and the 12-Item Short Form (SF-12) physical component score. Return to sport and patient satisfaction were documented. Clinical failures requiring revision surgery and complications were reported.
Preoperative baseline scores in both the tenodesis and SLAP repair groups were similar. There were no significant differences between the groups on any postoperative outcome measure: For biceps tenodesis versus SLAP repair, the ASES score was 92.7 ± 10.4 versus 89.1 ± 16.7, the SANE score was 86.2 ± 13.7 versus 83.0 ± 24.1, the QuickDASH score was 10.0 ± 12.7 versus 9.0 ± 14.3, and SF-12 was 51.2 ± 7.5 versus 52.8 ± 7.7. No group difference in return-to-sports rate (85% vs 79%; = .640) was noted. More patients in the tenodesis group (80%) reported modifying their sporting/recreational activity postoperatively because of weakness compared with patients in the SLAP repair group (15%; = .022). One patient in each group progressed to surgery for persistent postoperative stiffness, and 1 patient in the tenodesis group had a postoperative complication related to the index surgery.
Both subpectoral biceps tenodesis and SLAP repair provided excellent clinical results for the treatment of isolated SLAP type 2 lesions, with a high rate of return to overhead sports and a low failure rate, in a young and high-demanding patient cohort. More patients reported modifying their sporting/recreational activity because of weakness after subpectoral tenodesis.
对于患有孤立性上盂唇前后（SLAP）2型损伤的年轻过头运动运动员，SLAP修复或胸小肌下肱二头肌固定术哪种获益更多仍不清楚。
评估接受肱二头肌固定术或SLAP修复术的有症状SLAP 2型损伤的过头运动运动员的临床结局和恢复运动情况。
队列研究；证据等级，3级。
对前瞻性收集的数据进行回顾性分析，这些数据来自因孤立性2型SLAP损伤接受胸小肌下肱二头肌固定术（n = 14）或SLAP修复术（n = 24）的患者。所有患者手术时年龄均<35岁，参加过头运动，且手术至少已过去2年。用美国肩肘外科医师（ASES）评分、单项评估数值评定（SANE）评分、手臂、肩部和手部快速残疾（QuickDASH）评分以及12项简明健康调查（SF - 12）身体成分评分评估临床结局。记录恢复运动情况和患者满意度。报告需要翻修手术的临床失败情况和并发症。
固定术组和SLAP修复术组术前基线评分相似。两组在任何术后结局指标上均无显著差异：肱二头肌固定术与SLAP修复术相比，ASES评分为92.7±10.4对89.1±16.7，SANE评分为86.2±13.7对83.0±24.1，QuickDASH评分为10.0±12.7对9.0±14.3，SF - 12评分为51.2±7.5对52.8±7.7。未观察到恢复运动率的组间差异（85%对79%；P = 0.640）。与SLAP修复术组患者（15%；P = 0.022）相比，固定术组更多患者（80%）术后因无力而改变了其体育/娱乐活动。每组各有1例患者因术后持续僵硬而进展为再次手术，固定术组有1例患者发生与初次手术相关的术后并发症。
对于年轻且要求高的患者队列中孤立性SLAP 2型损伤的治疗，胸小肌下肱二头肌固定术和SLAP修复术均提供了出色的临床结果，恢复过头运动的比例高且失败率低。更多患者报告在胸小肌下肱二头肌固定术后因无力而改变了其体育/娱乐活动。
