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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis
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Prospective Randomized Study of Arthroscopic Proximal vs Open Subpectoral Biceps Tenodesis

机译：关节镜近端vs开放胸下肱二头肌腱固定的前瞻性随机研究

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Objectives: The biceps tendon is recognized as a significant source of pain in the shoulder for many patients. Operative techniques for tenodesis of the biceps tendon vary widely. No studies have been conducted directly comparing arthroscopic proximal vs. open subpectoral biceps tenodesis using a prospective study. We aim to compare the functional outcomes, pain relief, and complications of proximal vs. subpectoral biceps tenodesis. Methods: A prospective randomized study of 129 consecutive patients requiring biceps tenodesis for treatment of biceps tendon tears, biceps instability or superior labral tears was performed. Clinical outcome measures used to conduct the study included active range of motion, VAS pain score, ASES score and SANE scores. Complications and revisions were also documented. Results: Mean follow-up was 13.2 months (12-24 months) with 50 subpectoral tenodesis and 46 proximal tenodesis patients reaching minimum follow-up of 12 months. In the subpectoral group, the VAS improved from 5.7 to 2.0 (p < 0.001), ASES score improved from 49.8 to 77.7 (p< 0.001), and SANE scores improved from 42.1% to 77.7% (p<0.001). In the arthroscopic proximal tenodesis group, the VAS pain score improved from 5.9 to 1.8 (p<0.001), ASES score improved from 52.0 to 82.5 (p<0.001), and SANE scores improved from 42.8% to 78.6% (p<0.001). The revision rate for the subpectoral group was 4% (2/50 patients). The revision rate for the arthroscopic proximal tenodesis group was 8.6% (4/46). Twelve patients had persistent tenderness over the bicipital groove: 7 following proximal tenodesis and 5 following subpectoral tenodesis. No significant difference was found between methods in any outcome measures evaluated. Conclusion: This study found no difference in the functional outcomes or pain relief between proximal vs subpectoral biceps tenodesis. However, revision rates and occurrence of post-operative persistent bicipital groove pain for arthroscopic proximal tenodesis with internal fixation screw were slightly higher than in the subpectoral approach.
机译：目的：二头肌腱被认为是许多患者肩部疼痛的重要来源。二头肌腱腱固定术的手术技术差异很大。尚无一项使用前瞻性研究直接比较关节镜近端与开放式胸下肱二头肌腱狭窄的研究。我们旨在比较功能性结局，疼痛缓解以及近端与胸下肱二头肌腱狭窄的并发症。方法：一项前瞻性随机研究对129例需要二头肌腱固定术治疗二头肌腱撕裂，二头肌不稳定或上唇唇撕裂的患者进行了研究。用于进行研究的临床结局指标包括活动范围，VAS疼痛评分，ASES评分和SANE评分。还记录了并发症和修订。结果：平均随访时间为13.2个月（12-24个月），其中50例胸膜下肌腱膜病和46例近端肌腱膜病患者达到了至少12个月的随访。在胸下组中，VAS从5.7改善到2.0（p <0.001），ASES评分从49.8改善到77.7（p <0.001），SANE评分从42.1％改善到77.7％（p <0.001）。关节镜近端肌腱固定组中，VAS疼痛评分从5.9改善至1.8（p <0.001），ASES评分从52.0改善至82.5（p <0.001），SANE评分从42.8％改善至78.6％（p <0.001）。 。胸下组的修订率为4％（2/50例）。关节镜近端肌腱固定组的翻修率为8.6％（4/46）。 12名患者在二尖瓣沟上存在持续性压痛：近端肌腱固定后7例，胸膜下肌腱固定后5例。在评估的任何结果指标中，方法之间均未发现显着差异。结论：本研究发现近端肱二头肌和胸膜下肱二头肌之间的功能结局或疼痛缓解无差异。然而，带内固定螺钉的关节镜近端肌腱固定术的翻修率和术后持续性二尖瓣沟疼痛的发生率比胸膜下入路略高。

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