Ⅱ型SLAP损伤肱二头肌长头腱切断固定与修复的比较

Tenodesis of biceps long head tendon versus repair in situ for type II SLAP tear

[目的]比较肱二头肌长头腱切断固定术和上盂唇锚钉缝合修复术治疗II型SLAP损伤的临床疗效。[方法]回顾性分析本院2018年1月—2021年6月收治的31例II型SLAP损伤患者的临床资料,根据医患沟通结果,16例采用肱二头肌长头腱切断固定术治疗(腱固定组),15例采用带线锚钉缝合修复术(修复组),比较两组围手术期及随访结果。[结果]两组均顺利完成手术,两组手术时间、切口长度、术中失血量、主动活动时间、切口愈合和住院时间比较的差异均无统计学意义(P>0.05)。两组均获得至少1年的随访。两组完全负重活动时间的差异无统计学意义(P>0.05)。术后随时间推移,两组VAS、ASES、QuickDASH和Constant-Murley评分均显著改善(P<0.05)。术后3个月,腱固定组的VAS评分[(2.5±0.5) vs (3.7±1.0), P<0.001]显著优于修复组。末次随访,腱固定组的ASES [(93.7±1.8) vs (90.3±3.3), P=0.002]、QuickDASH [(8.9±1.9) vs (11.0±1.6), P=0.002]和Constant-Murley评分[(93.8±1.5) vs (91.1±3.1), P=0.006]均显著优于修复组,但两组VAS评分的差异已无统计学意义(P>0.05)。[结论]肱二头肌长头腱切断固定术和上盂唇的带线锚钉缝合修复术在治疗II型SLAP损伤上均有良好的效果,相比之下,肱二头肌长头腱切断固定术在患者术后半年的体验及疗效,较修复术更优。

[Objective]To compare the clinical efficacy of tenodesis of biceps long head tendon versus repair in situ for type II superior labrum anterior to posterior(SLAP)tear.[Methods]Clinical data of 31 patients with type II SLAP injury admitted to our hospital from Janu⁃ary 2018 to June 2021 were retrospectively analyzed.According to the results of doctor-patient communication,16 patients were treated with tenodesis of biceps long head tendon(tenodesis group),while other 15 patients were treated with repair in situ by suture anchor(the re⁃pair group).The perioperative period and follow-up results of the two groups were compared.[Results]The operation was successfully com⁃pleted in both groups,with no significant differences in operation time,incision length,intraoperative blood loss,active activity time,inci⁃sion healing and hospital stay between the two groups(P>0.05).All patients in both groups were followed for more than 1 year,and there was no significant difference in the time to regain full weight-bearing activities between the two groups(P>0.05).As time went by,the VAS,ASES,QuickDASH and Constant-Murley scores were significantly improved in both groups(P<0.05).The tenodesis group proved signifi⁃cantly superior to the repair group regarding the VAS score 3 months after surgery[(2.5±0.5)vs(3.7±1.0),P<0.001].Moreover,the tenode⁃sis group was significantly better than the repair group in terms of ASES[(93.7±1.8)vs(90.3±3.3),P=0.002],QuickDASH[(8.9±1.9)vs(11.0±1.6),P=0.002]and Constant-Murley scores[(93.8±1.5)vs(91.1±3.1),P=0.006]at the last follow-up,although the difference in VAS scores between the two groups became not statistically significant at that time(P>0.05).[Conclusion]Both biceps long head tenodesis and repair in situ by suture anchor do achieve satisfactory outcomes in the treatment of type II SLAP injury.In comparison,the biceps long head tenodesis is superior to the repair in situ in terms of experience and efficacy more than six months after surgery.