关节镜下保留肌腱的固定术治疗肱二头肌长头肌腱炎

Arthroscopic tenodesis with tendon preservation for biceps long head tendinitis

目的探讨肩关节镜下保留眩二头肌长头腱的肌腱固定术治疗眩二头肌长头肌腱炎早期临床疗效。方法2013年10月至2014年4月，对43例眩二头肌长头肌腱炎患者施行保留眩二头肌长头腱的肌腱固定术，其中男16例，女27例，年龄39-60岁，平均50．6岁。术前与术后3、6、12个月进行Constant-Murley肩关节评分、加利福尼亚大学洛杉矶分校（UCLA）肩关节评分及美国肩肘外科协会（ASES）评分。结果所有患者术程顺利，平均随访14．2个月（12～18个月）。术前ASES评分为（15．65±6．06）分，Constan-Murley肩关节评分为（39．80±11．21）分，UCLA肩关节评分为（13．25±3．77）分，术后12个月ASES评分为（34．70±2．47）分，Constant-Murley肩关节评分为（86．00±6．35）分，UCLA肩关节评分为（31．75±2．40）分。术后ASES评分、Constant-Murley肩关节评分、UCLA肩关节评分较术前有明显提高，差异均有统计学意义（P〈0．001）。术后患者疼痛缓解，未出现复发，无一例发生眩二头肌长头腱回缩引起的大力水手征。结论肩关节镜下保留眩二头肌长头腱的肌腱固定术治疗眩二头肌长头肌腱炎早期疗效满意，可有效避免肌腱止点固定松动导致的肌腱回缩相关并发症，是治疗眩二头肌长头肌腱炎的有效治疗方法。

Objective To explore the early clinical efficacy of arthroscopic tenodesis with tendon preservation for biceps long head tendinitis.Methods From October 2013 to April 2014,43 patients of biceps long head tendinitis were treated with arthroscopic tenodesis with tendon preservation.There were 16 males and 27 females,with an average age of 50.6 years(range,39-60 years).American shoulder and elbow surgeons(ASES),Constant-Murley shoulder score and the University of California at Los Angeles(UCLA)shoulder scale were assessed in pre-operation and 3,6,12 months after opertion.Results All patients successfully completed the surgery.The average follow-up period was 14.2 months(range,12-18 months).The mean of ASES score,Constant-Murley shoulder score and UCLA shoulder scale were 15.65±6.06,39.80±11.21 and 13.25±3.77 in pre-operation respectively,and they were 34.70±2.47,86.00±6.35 and 31.75±2.40 in 12 months after operation respectively.The outcomes demonstrated that all scores in12 months after operation significantly improved(P<0.05).There was no pain recurrence and Popeye syndrome caused by transposition of tendon among these patients after operation.Conclusion Arthroscopic tenodesis with tendon preservation could achieve a satisfactory efficacy in the treatment of biceps long head tendinitis.This surgical method that preserves biceps brachii can effectively avoid the complications caused by transposition of tendon during fixation,thus it is a better treatment method for biceps long head tendinitis.