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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Effect of Age, Gender, And BMI on the Incidence and Satisfaction of A Popeye Deformity Following Biceps Tenotomy or Tenodesis: Outcomes of A Multicenter Randomized Controlled Trial
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Effect of Age, Gender, And BMI on the Incidence and Satisfaction of A Popeye Deformity Following Biceps Tenotomy or Tenodesis: Outcomes of A Multicenter Randomized Controlled Trial

机译：年龄，性别和BMI对二头肌或成本术后效率畸形的发病率和满意度：多中心随机对照试验的结果

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Objectives: The purpose of this study was to 1) determine the rates of popeye deformity following biceps tenotomy versus tenodesis 2) identify predictors for developing a deformity, and 3) report the subjective and objective outcomes in patients with a popeye deformity. Methods: Data for this study were collected as part of a randomized clinical trial comparing tenodesis versus tenotomy in the treatment of lesions of the long head of biceps tendon. Patients 18 years of age or older undergoing arthroscopic shoulder surgery with intraoperative confirmation of a lesion of the long head of the biceps tendon randomized to one of these techniques were included. The primary outcome measure for this sub-study was the rate of a popeye deformity at 24-months post-operative as determined by an evaluator blinded to group allocation. Secondary outcomes were presence/absence of a popeye deformity based on patients responding to the following question: “Do you notice a bulge on the front of your upper arm above your elbow?” If yes, patients indicated their satisfaction with the appearance of their arm on a 10 cm visual analog scale (VAS) with 0=“Unsatisfactory” and 10=“Satisfactory” as the anchors. Patients were also asked to indicate if they experienced pain or cramping on a VAS, and complete the American Shoulder and Elbow Score (ASES) and the Western Ontario Rotator Cuff score (WORC). Isometric elbow flexion and supination strength (ratio of affected and unaffected) were also measured. Kappa was calculated to measure interrater reliability between patient and evaluator on the presence of a deformity, and logistic regression was used to identify possible predictors of its occurrence. Pearson correlations were performed to identify factors associated with dissatisfaction in appearance. Results: Fifty-seven participants were randomly assigned to each group of which 42 in the tenodesis group and 45 in the tenotomy group completed a 24-month follow-up. The overall incidence of popeye deformity based on clinical assessment was 21%, 9.5% (4/42) in the tenodesis group and 33% (15/45) in the tenotomy group. The odds of a popeye deformity resulting from a tenotomy was 4.3 times that of tenodesis (OR 4.3, 95% CI: 1.25-14.76; p=0.018). Gender was tending towards significance with males having 7.3 greater odds of a perceived deformity (p=0.067), while age and BMI were not predictive. There were no differences between those with and without a perceived deformity with respect to subjective and functional outcome measures. Based on patient self-assessment, the overall incidence of a deformity was 18%, 25% in the tenotomy group and 10% in the tenodesis group. The odds of a patient reporting a popeye deformity following tenotomy was 3.66 relative to tenodesis (OR=3.66, CI 95% 1.08-12.44; p=0.038). Gender, BMI, and age were not predictive of self-report of a popeye. Those with and without a self-reported popeye deformity differed with respect to pain (p=0.001), cramping (0.039), and WORC scores (p&0.006), there was no difference in ASES or elbow strength. Of those who reported having a deformity, mean (SD) satisfaction score reported on the appearance of their arm was 7.3 (2.6). Increasing satisfaction score was significantly correlated with increasing patient age (r=0.640; p=0.025) but there was no association with gender or BMI. Inter-rater agreement between clinical assessment and self-reported popeye deformity was substantial with a kappa of 0.635 (p&0.001). However, 8% (7/87) of patients with a popeye deformity did not perceive it and 3% (3/87) of patients reported a popeye deformity that was not detected by the clinical assessor. Conclusions: The odds of observing a popeye deformity based on clinical assessment following tenotomy was 4.3 times higher than tenodesis at 24-months post-operative. Male gender may contribute to increased incidence, while age and BMI were not major contributors to the presence/absence of a popeye. In patients who reported a popeye deformity, increasing age was associated with increased satisfaction in the appearance of the arm.
机译：目的：本研究的目的是1）确定二头肌的逐渐变形率为奇异果关系2）识别造成畸形的预测因子，3）报告患者患者畸形患者的主观和客观结果。方法：本研究的数据作为随机临床试验的一部分，比较了雌雄同体对肌腱的长头的病变治疗术治疗病变的一部分。包括18岁或更老的患者接受关节镜肩部手术，术中术后确认二头肌肌腱的长头随机化为其中一种技术。该子研究的主要结果措施是在术后24个月的效率畸形的速率，该评估员由盲目盲目盲目分配确定。二次结果是基于回应以下问题的患者的患者存在/缺乏效率畸形：“您是否在肘部上方的上臂正面注意到凸起？”如果是的话，患者表明他们的臂在10cm视觉模拟（VAS）上的外观满意，0 =“不令人满意”和10 =“令人满意”作为锚点。还要求患者表明它们是否在VAS上经历了疼痛或痉挛，并完成美国肩部和肘部分数（ASES）和西部的Ontario Rotator Cuff评分（WORC）。还测量了等距弯头屈曲和脱水强度（受影响和不受影响的比率）。计算Kappa以测量患者和评估器之间的Interratister可靠性，在存在畸形的情况下，使用Logistic回归来识别其发生的可能预测因子。进行Pearson相关性以识别与外观不满相关的因素。结果：五十七名参与者被随机分配给每个小组，其中42个在尼古特集团中的42群体，并在Tenotomy Group中完成了24个月的随访。基于临床评估的基波普畸形的总体发病率为21％，奇异作用组中的9.5％（4/42），在腱鞘组中为33％（15/45）。由协调术引起的POPEYE畸形的几率为成本的4.3倍（或4.3,95％CI：1.25-14.76; P = 0.018）。性别倾向于与感知畸形的较大少量较大的男性倾向于具有7.3（P = 0.067）的雄性，而年龄和BMI没有预测。在主观和功能结果措施方面没有感知畸形的人之间没有差异。基于患者自我评估，畸形的总发病率为18％，在腱鞘组中的25％，25％，在尼古氏体组中10％。患者报告协调术后的患者的含量为3.66，相对于成本为3.66（或= 3.66，CI 95％1.08-12.44; P = 0.038）。性别，BMI和年龄没有预测职业的自我报告。有没有自我报告的效率畸形的那些与疼痛（p = 0.001），痉挛（0.039）和WORC分数（P＆amp; 0.006）不同，因此ases或肘部强度没有差异。报告的那些患有畸形的人，意思（SD）满意度评分报告其ARM的外观为7.3（2.6）。随着患者年龄的增加（r = 0.640; p = 0.025）而言，增加的满意度得分显着相关，但与性别或BMI没有关联。临床评估和自我报告的POPEYE畸形之间的帧间间协议与kappa为0.635（P＆amp; 0.001）。然而，8％（7/87）的患者患者畸形没有感知，3％（3/87）患者报告了临床评估员未检测到的效率畸形。结论：在术后24个月后，基于协调术后，观察基于临床评估的临床评估的部位畸形的几率高4.3倍。男性性别可能会导致发病率增加，而年龄和BMI则没有对职位的存在/缺失的主要贡献者。在报告患者畸形的患者中，增加年龄与手臂外观的满意度增加。

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