Waterman Brian R, Newgren Jon, Richardson Catherine, Romeo Anthony A
Wake Forest Baptist Health, Winston-Salem, North Carolina, USA.
Rush University Medical Center, Chicago, Illinois, USA.
Arthroscopy. 2023 Jan;39(1):11-16. doi: 10.1016/j.arthro.2022.07.017. Epub 2022 Aug 18.
To evaluate the functional and athletic outcomes after primary subpectoral biceps tenodesis for type II SLAP tear in overhead athletes.
All competitive elite athletes with type II SLAP tears undergoing biceps tenodesis by a single surgeon were isolated between 2007 and 2015. Exclusion criteria were applied to individuals not involved in overhead athletics, clinical follow-up <24 months, adjacent rotator cuff or labral repair, concomitant SLAP repair, and/or previous arthroscopic shoulder surgery. Patient-reported outcome measures included visual analog scale (VAS), Kerlan Jobe Orthopaedic Clinic shoulder score, and Single Assessment Numerical Assessment. Clinical and sporting outcomes were recorded using a sports-specific questionnaire.
Of 22 identified patients, 16 competitive overhead athletes (72.7%; 11 men, 5 women) with a mean age of 21.0 years were available at mean 4.5-year follow-up. Baseball or softball comprised the majority of patients (n = 9; 56.3%), followed by gymnastics (n = 2), swimming (n = 2), and other sports (n = 3). At mean 4.1 months postoperatively, 13 patients (81.3%) returned to previous level of athletic activity, whereas 2 patients (12.5%) failed to return to sporting activity and 1 (6.3%) returned at a lower level of competition. VAS pain significantly decreased from an average of 4.4 preoperatively to 1.7 postoperatively (P = .002), and mean Single Assessment Numerical Assessment scores also demonstrated significant improvement (55.4-76.7; P = .008). Final mean Kerlan Jobe Orthopaedic Clinic score was 74.0 (standard deviation 25.9), including 2 patients with suboptimal outcomes due to persistent pain. There were no significant differences in mean forward flexion or rotation in either the adducted or throwing position (P > .05), although small, significant decreases in postoperative active abduction were noted (165° vs 155°; P = .003).
In the current series of competitive overhead athletes, 81% of patients returned to previous level of play at an average of 4.1 months postoperatively after subpectoral biceps tenodesis for symptomatic SLAP tear. Athletes reliably experienced significant decreased activity-related pain with athletic function.
IV, case series.
评估原发性胸小肌下肱二头肌固定术治疗过头运动运动员Ⅱ型SLAP损伤后的功能和运动结局。
2007年至2015年间，纳入所有由同一位外科医生进行肱二头肌固定术治疗Ⅱ型SLAP损伤的竞技精英运动员。排除标准适用于不参与过头运动的个体、临床随访时间<24个月、合并肩袖或盂唇修复、同时进行SLAP修复和/或既往有肩关节镜手术史的患者。患者报告的结局指标包括视觉模拟量表（VAS）、克伦·乔布骨科诊所肩部评分和单项评估数值评定法。使用特定运动问卷记录临床和运动结局。
在确定的22例患者中，有16名竞技过头运动运动员（72.7%；11名男性，5名女性）在平均4.5年的随访中可用。棒球或垒球运动员占大多数（n = 9；56.3%），其次是体操运动员（n = 2）、游泳运动员（n = 2）和其他运动项目运动员（n = 3）。术后平均4.1个月时，13例患者（81.3%）恢复到之前的运动水平，而2例患者（12.5%）未能恢复运动，1例（6.3%）以较低的竞技水平恢复运动。VAS疼痛评分从术前平均4.4显著降至术后1.7（P = .002），单项评估数值评定法的平均得分也显示出显著改善（55.4 - 76.7；P = .008）。最终克伦·乔布骨科诊所平均评分为74.0（标准差25.9），其中2例患者因持续疼痛结局欠佳。内收或投掷位的平均前屈或旋转角度无显著差异（P > .05），尽管术后主动外展有小幅度但显著的下降（165°对155°；P = .003）。
在本系列竞技过头运动运动员中，因症状性SLAP损伤行胸小肌下肱二头肌固定术后，81%的患者在术后平均4.1个月恢复到之前的运动水平。运动员的与活动相关疼痛明显减轻，运动功能可靠改善。
IV，病例系列。
