背景:本研究旨在报告LHB肌腱切开术后肱二头肌相关并发症的发生率,调查相关危险因素及其对结局的影响。假设是这些并发症具有有限的临床影响。方法:2015年至2017年,对接受LHB肌腱切开术相关RCR的连续患者进行了一项单中心前瞻性观察性研究。术前对患者进行了临床和放射学评估,六个月零一年,并筛查了术后乳房畸形,抽筋,还有二头肌不适.分析每种并发症的以下危险因素:年龄,性别,体重指数(BMI),优势臂,手工作业,撕裂模式,和肌腱愈合。最后,比较有无并发症患者的临床结局.结果:对207例患者进行分析。抽筋,美人畸形,和不适,分别是,出现在16个(7.7%),38例(18.4%)和52例(25.1%)在六个月和17例(8.2%),一年18例(8.7%)和24例(11.6%)。抽筋与年龄较低有关(p=0.0005),较高的BMI(p=0.0251),单肌腱撕裂(p=0.0168),6个月体力劳动(p=0.0086),1年体力劳动(p=0.0345)。Popeye畸形与六个月时的男性性行为有关(p&lt;0.0001)。不适与年龄较低有关(p=0.0065),手工作业(p=0.0099),六个月和体力劳动(p=0.0200)时的大人物畸形(p=0.0240),单肌腱撕裂(p=0.0370),一年后出现玉眼畸形(p=0.0033)。无并发症的患者表现出显著较高的Constant评分,疼痛和主观肩部值(SSV)(75.3vs.70.4,p=0.00252;0.9vs.1.9,p<0.00001;80.2vs.76.4;p=0.00124)在六个月和疼痛和SSV(0.6vs.2.0;p=0.00044;91.1与77.8;p≤0.00001)一年。结论:年龄较小,男性,BMI较高,手工作业,而单肌腱撕裂是肌腱切开术后1年内与肱二头肌相关症状发展相关的危险因素。然而,这些症状对肩关节结局的临床影响有限.
Background: This study aims to report the rate of biceps-related complications after LHB tenotomy, investigating related risk factors and their influence on the outcome. The hypothesis is that these complications have a limited clinical influence. Methods: A single-center prospective observational study was performed between 2015 and 2017 on consecutive patients who underwent RCR associated with LHB tenotomy. Patients were clinically and radiologically evaluated preoperatively, at six months and one year, and screened for postoperative popeye deformity,
cramps, and bicipital discomfort. Each complication was analyzed for the following risk factors: age, sex, body mass index (BMI), dominant arm, manual work, tear patterns, and tendon healing. Finally, the clinical outcome was compared between patients with and without complications. Results: 207 patients were analyzed.
Cramps, popeye deformity, and discomfort, were respectively, present in 16 (7.7%), 38 (18.4%) and 52 (25.1%) cases at six months and 17 (8.2%), 18 (8.7%) and 24 (11.6%) cases at one year.
Cramps were associated with lower age (p = 0.0005), higher BMI (p = 0.0251), single tendon tear (p = 0.0168), manual work (p = 0.0086) at six months and manual work (p = 0.0345) at one year. Popeye deformity was associated with male sex at six months (p < 0.0001). Discomfort was associated with lower age (p = 0.0065), manual work (p = 0.0099), popeye deformity (p = 0.0240) at six months and manual work (p = 0.0200), single tendon tear (p = 0.0370), popeye deformity (p = 0.0033) at one year. Patients without complications showed a significant higher Constant score, pain and subjective shoulder value (SSV) (75.3 vs. 70.4, p = 0.00252; 0.9 vs. 1.9, p < 0.00001; 80.2 vs. 76.4; p = 0.00124) at six months and pain and SSV (0.6 vs. 2.0; p = 0.00044; 91.1 vs. 77.8; p ≤ 0.00001) at one year. Conclusions: Younger age, male sex, higher BMI, manual work, and single tendon tears are risk factors associated with the development of biceps-related symptoms during the first year after tenotomy in association with rotator cuff repair. Nevertheless, the clinical influence of these symptoms on shoulder outcomes is limited.