Huang Yen-Wei, Wang Pu-Kuang, Hung Shen-Wu, Chen Yu-Pin, Chang Wei-Chun, Kuo Yi-Jie, Chuang Tai-Yuan
Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taiwan.
Department of Orthopedics, Wan Fang Hospital, Taipei Medical University, Taiwan.
Asia Pac J Sports Med Arthrosc Rehabil Technol. 2025 Sep 9;42:47-53. doi: 10.1016/j.asmart.2025.08.002. eCollection 2025 Oct.
This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.
Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.
Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores ( < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity ( = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C ( = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.
For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.
Level III, retrospective comparative study.
本研究比较了T形肱二头肌肌腱切断术（肱二头肌长头腱与部分上盂唇松解）与传统圆柱形肱二头肌肌腱切断术（不包括盂唇）在可修复性肩袖撕裂合并肱二头肌长头腱损伤患者中的临床疗效。
在接受关节镜下肩袖撕裂修复及肱二头肌长头腱合并损伤治疗的患者中，评估了89例年龄≥65岁接受T形肱二头肌肌腱切断术的患者（T组；n = 46）和接受传统圆柱形肱二头肌肌腱切断术的患者（C组；n = 43）。记录了“大力水手”畸形的存在、痉挛性疼痛的严重程度、肘关节屈曲力量和前臂旋后力量。通过超声评估肱二头肌残端的解剖状态。当在结节间沟未发现肱二头肌肌腱时，视为解剖失败。
总体而言，86例患者（T组45例，C组41例）接受了超过2年的监测。他们的术后功能评分显著优于术前评分（P < 0.03），两组之间无显著差异。T组3例患者（6.7%）和C组9例患者（22.0%）出现“大力水手”畸形（P = 0.036）。超声检查显示T组5例患者（11.1%）和C组13例患者（31.7%）存在解剖失败（P = 0.021）。对术后痉挛性疼痛和肘关节屈曲力量进行了评估，两组之间无显著差异。
对于治疗肩袖撕裂患者合并的肱二头肌长头腱损伤，涉及部分上盂唇的T形肌腱切断术是不涉及盂唇的传统圆柱形肌腱切断术的可接受替代方案。与传统圆柱形肌腱切断术相比，T形肌腱切断术具有相似的功能结局，且术后“大力水手”畸形的发生率较低。
III级，回顾性比较研究。
