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部分肩袖上盂唇止点撕脱修复及修补术:肱二头肌长头腱增强肩袖再固定技术

Partial Articular Supraspinatus Tendon Avulsion Repair and Patch: A Technical Note for Augmenting the Supraspinatus Reinsertion with the Long Head of the Biceps Tendon.

机构信息

Romanian Shoulder Institute, ORTOPEDICUM-Orthopaedic Surgery & Sports Clinic, Bucharest, Romania.

SportsOrtho Department, Zetta Hospital, Bucharest, Romania.

出版信息

Orthop Surg. 2023 Aug;15(8):2174-2180. doi: 10.1111/os.13856.

Abstract

BACKGROUND

There is no clear consensus on the treatment of partial articular-sided supraspinatus tendon avulsions. Debridement alone might not be sufficient to prevent further tendon degradation or alleviate patient complaints. Direct repair using a suture anchor without treating the concomitant conditions of the long head of the biceps tendon might come with residual anterior shoulder pain or even further loss of function in cases of failed repair. The purpose of the present study is to describe an arthroscopic technique by which the long head of the biceps tendon can be included in the partial articular-sided supraspinatus tendon avulsion repair.

TECHNIQUE PRESENTATION WITH VIDEO

In this technical note we describe the arthroscopic repair and augmentation with tenotomized biceps of partial supraspinatus tendon tears to address three main concepts for successful rotator cuff repairs, namely rotator cuff biologic augmentation, tendon to bone healing and postoperative pain prevention.

CONCLUSION

The biceps tendon is a mechanically robust, locally available autograft that can be used in borderline partial articular-sided supraspinatus tendon avulsions in order to biologically augment healing at the tendon-bone interface without any immunogenic reactions or morbidity following harvesting.

摘要

背景

对于部分关节侧肩袖冈上肌腱撕脱的治疗,目前尚无明确共识。单纯清创可能不足以防止进一步的肌腱退化或减轻患者的抱怨。如果不治疗肱二头肌长头肌腱的伴随状况,直接使用缝合锚钉进行直接修复,可能会残留前肩痛,甚至在修复失败的情况下进一步丧失功能。本研究的目的是描述一种关节镜技术,通过该技术可将肱二头肌长头肌腱纳入部分关节侧冈上肌腱撕脱修复中。

技术介绍(带视频):在本技术说明中,我们描述了关节镜下修复和肱二头肌肌腱切断术增强治疗部分肩袖冈上肌腱撕裂,以解决成功的肩袖修复的三个主要概念,即肩袖生物增强、肌腱到骨愈合和术后疼痛预防。

结论

肱二头肌肌腱是一种机械强度高、局部可用的自体移植物,可用于边界性部分关节侧肩袖冈上肌腱撕脱,以在肌腱-骨界面进行生物增强愈合,而不会在采集后产生任何免疫反应或发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b9f/10432445/e242a5cc655a/OS-15-2174-g001.jpg

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