Akpinar Berkcan, Vasavada Kinjal, Colasanti Christopher A, Alaia Michael J, Strauss Eric J, Jazrawi Laith M
NYU Langone Orthopedic Hospital, New York, New York, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jun 4;4(4):e1299-e1304. doi: 10.1016/j.asmr.2022.04.007. eCollection 2022 Aug.
To determine whether an association exists between the presence of cervical spine pathology and postoperative patient-reported outcomes (PROs) in patients undergoing open subpectoral biceps tenodesis (BT).
A retrospective review of patients undergoing isolated BT from August 2011 to May 2019 was conducted. Cases were defined as patients with concomitant cervical spine disease (disc disease, disc herniations, neuroforaminal/central stenosis). Controls were patients without cervical spine disease. Postoperative PROs were collected from all patients with a minimum of 12-month follow-up. Cases and controls were matched 1:1 using age and body mass index. PROs were compared using the χ text, Fisher exact test, or analysis of variance.
A total of 23 cases and 23 controls were identified. Cases and controls had similar distributions of age (42.4 ± 4.4 years, 40.4 ± 4.5, = .15), sex (83% male, 87% male, = .68), body mass index (28.0 ± 4.0, 27.6 ± 4.3, = .78), and percentage of athletes (65% athlete, 61% athlete. = .76). All cases had evidence of neuroforaminal stenosis and multilevel degenerative disc disease, whereas 19 of 23 (83%) had evidence of central canal stenosis. Cases had a greater visual analog scale (VAS) score during Sport score (3.6 ± 0.7 vs 1.2 ± 0.6, = .013) and lower Subjective Shoulder Value (69.5 ± 5.8 vs 84.1 ± 5.4, = .070) and Shoulder Instability-Return to Sport after Injury score (60.4 ± 5.8 vs 77.4 ± 6.0, = .046). There were no significant differences between groups' ASES, baseline VAS, overall satisfaction scores, and willingness to undergo the same operation again. No significant differences were found in postoperative rate of return to sport, time to return, and return to preoperative competitiveness.
Patients with SLAP tears undergoing isolated BT in the presence of cervical spinal stenosis may have inferior Subjective Shoulder Value, Shoulder Instability-Return to Sport after Injury, and VAS during sport scores as compared with controls, although many PROs were similar at follow-up. Athletes undergoing BT, particularly with concomitant cervical spine pathology, should be counseled appropriately before surgery.
Level III, case-control study.
确定接受开放性胸小肌下肱二头肌肌腱固定术（BT）的患者中，颈椎病理状况与术后患者报告结局（PROs）之间是否存在关联。
对2011年8月至2019年5月接受单纯BT的患者进行回顾性研究。病例定义为伴有颈椎疾病（椎间盘疾病、椎间盘突出、神经孔/中央管狭窄）的患者。对照组为无颈椎疾病的患者。对所有至少随访12个月的患者收集术后PROs。病例和对照组按年龄和体重指数1:1匹配。使用χ检验、Fisher精确检验或方差分析比较PROs。
共确定23例病例和23例对照。病例组和对照组在年龄（42.4±4.4岁，40.4±4.5岁，P = .15）、性别（男性83%，男性87%，P = .68）、体重指数（28.0±4.0，27.6±4.3，P = .78）和运动员比例（运动员65%，运动员61%，P = .76）方面分布相似。所有病例均有神经孔狭窄和多节段退变性椎间盘疾病的证据，而23例中有19例（83%）有中央管狭窄的证据。病例组在运动评分时的视觉模拟量表（VAS）评分更高（3.6±0.7 vs 1.2±0.6，P = .013），主观肩部评分更低（69.5±5.8 vs 84.1±5.4，P = .070），肩部不稳定-伤后恢复运动评分更低（60.4±5.8 vs 77.4±6.0，P = .046）。两组在美国肩肘外科医师学会（ASES）评分、基线VAS评分、总体满意度评分以及再次接受相同手术的意愿方面无显著差异。在术后恢复运动率、恢复时间和恢复到术前竞技水平方面也未发现显著差异。
与对照组相比，存在颈椎管狭窄的接受单纯BT治疗的肩袖损伤患者在主观肩部评分、肩部不稳定-伤后恢复运动评分以及运动评分时的VAS评分可能较差，尽管许多PROs在随访时相似。接受BT治疗的运动员尤其是伴有颈椎病理状况的运动员，术前应给予适当的咨询。
Ⅲ级，病例对照研究。
