Glover Mark A, Restrepo Alexis, Recker Andrew J, Beck Edward C, Bullock Garrett S, Trasolini Nicholas A, Waterman Brian R
Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.
Department of Orthopaedic Surgery and Rehabilitation, Atrium Health Wake Forest Baptist Health, Winston-Salem, North Carolina, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Dec 19;6(1):100840. doi: 10.1016/j.asmr.2023.100840. eCollection 2024 Feb.
To characterize clinical and patient-reported outcomes for patients after isolated biceps tenodesis (BT) who underwent either standard or expedited sling immobilization protocols following surgery.
This retrospective cohort study compared patients who were assigned to use a sling for either 4 to 6 weeks (standard) or 0 to 2 weeks (expedited) following an isolated BT. Primary endpoint included rate of re-rupture, surgical revision, loss of fixation, and Popeye deformity. Secondary endpoints included shoulder range of motion (ROM) as well as pre- and postoperative patient-reported outcomes (PROs) of pain and function. Missing data were managed via multiple imputation with chained equations. Complication prevalence 95% confidence intervals were calculated using the Clopper Pearson method and a series of hierarchical mixed effects linear regressions were performed to assess differences between sling interventions in PROs and ROM.
The average age of the standard cohort (n = 66) was 49 years (±14 years), and the average age of the expedited cohort (n = 69) was 47 years (±14 years). The expedited and standardized cohorts demonstrated 0.4 and 0.3 complications per 10,000 exposure days, respectively, with no significant difference between groups (1.4 [95% confidence interval 0.2-10.0], = .727). There was no demonstrated difference in forward flexion, abduction, or external ROM. The expedited group had less improvement in visual analog scale for pain scores that was not clinically significant and there were no differences in PROs of function.
No statistically significant difference in the rate of re-rupture, surgical revision, loss of fixation, or Popeye deformity was noted between protocols after isolated BT. Furthermore, there were no clinically significant differences in ROM or PROs identified between protocols after isolated BT. This study suggests that patients who have undergone isolated BT may safely discontinue sling use within 2 weeks after surgery.
Level III, retrospective comparative study.
描述接受单纯肱二头肌固定术（BT）的患者在术后采用标准或加速吊带固定方案后的临床及患者报告结局。
这项回顾性队列研究比较了在单纯BT术后被分配使用吊带4至6周（标准组）或0至2周（加速组）的患者。主要终点包括再断裂率、手术翻修率、固定失败率和肱二头肌畸形。次要终点包括肩关节活动范围（ROM）以及术前和术后患者报告的疼痛和功能结局（PROs）。缺失数据通过链式方程多重填补法处理。采用Clopper Pearson方法计算并发症发生率的95%置信区间，并进行一系列分层混合效应线性回归分析，以评估吊带干预措施在PROs和ROM方面的差异。
标准组（n = 66）的平均年龄为49岁（±14岁），加速组（n = 69）的平均年龄为47岁（±14岁）。加速组和标准组每10000暴露日的并发症发生率分别为0.4和0.3，两组之间无显著差异（1.4 [95%置信区间0.2 - 10.0]，P = 0.727）。在前屈、外展或外旋ROM方面未显示出差异。加速组在疼痛视觉模拟量表评分上的改善较小，但无临床意义，在功能PROs方面也无差异。
单纯BT术后，不同方案在再断裂率、手术翻修率、固定失败率或肱二头肌畸形发生率方面无统计学显著差异。此外，单纯BT术后不同方案在ROM或PROs方面也无临床显著差异。本研究表明，接受单纯BT的患者在术后2周内可安全停用吊带。
III级，回顾性比较研究。
