Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears.
Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears.
复制标题
肩袖完全撕裂二头肌长头肌腱病理分类与分析
DOI：
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
K. Hsu
中科院分区：
文献类型：
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作者：
Chien;Chih;Chih;C. Su;Kun;I. Wang;Hsien;Chung;K. Hsu
背景
肱二头肌长头肌腱（LHB）的病理学通常与肩袖撕裂（RCT）相关。随机对照试验中也可能发生上级盂唇前后（Swiss）病变。本研究的目的是在RCT的手术病例中纳入作为LHB病理学一部分的骶髂病变，并确定骶髂病变在RCT中的作用。
方法
我们回顾性分析了176例接受手术的完全RCT患者的临床资料。手术期间，对LHB进行了关节镜检查。采用改良的6型分类法描述这些病例的LHB病理：肌腱炎、半脱位、脱位、部分撕裂、完全断裂和肌腱损伤。统计分析LHB病理与不同RCT特征的关系。
结果
在RCT病例中，33%为1型（肌腱炎），11%为2型（半脱位），9%为3型（脱位），16%为4型（部分撕裂），7%为5型（完全断裂），6%为6型（肌腱断裂）病变。其余18%的病例没有明显的LHB病理。LHB病理与长时间（> 3个月）、大面积（> 5 cm（2））和多处或肩胛下肌腱受累的RCT相关。74%的肩关节受累患者同时接受了LHB病理和RCT手术。
结论
大多数慢性、大量和多发性或肩胛下肌腱受累的RCT患者也有LHB损伤。肩袖损伤，我们将其归类为LHB病理学的一个亚组，应在肩袖手术中识别并适当治疗。
BACKGROUND
Pathology of the long head of the biceps tendon (LHB) is commonly associated with rotator cuff tears (RCTs). Superior labral anterior-posterior (SLAP) lesions can also occur with RCTs. The purpose of this study was to include SLAP lesions as part of LHB pathology in surgical cases of RCT and define the role of SLAP lesions in RCTs.
METHODS
We retrospectively evaluated clinical data from 176 cases of complete RCT undergoing surgery. During surgery, the LHB was arthroscopically examined. A modified 6-type classification was used to describe the LHB pathology in these cases: tendinitis, subluxation, dislocation, partial tear, complete rupture and SLAP lesions. The relationship of LHB pathology to different characteristics of RCTs was statistically analyzed.
RESULTS
Of RCT cases, 33% had Type 1 (tendinitis), 11% had Type 2 (subluxation), 9% had Type 3 (dislocation), 16% had Type 4 (partial tear), 7% had Type 5 (complete rupture) and 6% had Type 6 (SLAP) lesions. The remaining 18% of cases had no obvious LHB pathology. LHB pathology were associated with RCTs of a long duration (> 3 months), large area (> 5 cm(2)), and multiple or subscapularis tendon involvement. Seventy four percent of patients with affected shoulders underwent simultaneous surgery for both LHB pathology and RCTs.
CONCLUSION
Most patient with RCTs with chronic, massive, and multiple or subscapularis tendon involvement also had LHB injury. SLAP lesions, which we classified as a subgroup of LHB pathology, should be identified during rotator cuff surgery and treated appropriately.