Biceps Tenodesis/Tenotomy Disrupts Biomechanical Glenohumeral Stability in the Setting of Superior Labrum Anteroposterior Tear and Repair.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Hayk Stepanyan, Aaron T Hui, Victor T Hung, Michelle H McGarry, Charles Long, Gregory J Adamson, Thay Q Lee
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引用次数: 0

Abstract

Purpose: To compare the biomechanical stability of the glenohumeral joint both before and after a SLAP tear to: (1) posterior SLAP repair, (2) posterior plus anterior SLAP repair, (3) biceps tenodesis with SLAP repair, and (4) biceps tenodesis without SLAP repair.

Methods: Eight cadaveric shoulders were tested using a custom testing system. Twenty-two-Newton glenohumeral compressive force and 5-N biceps load was applied. All testing was performed in 30° and 60° of glenohumeral abduction. Humeral rotational range of motion was measured with 2.2 Nm torque. Glenohumeral anteroposterior (AP) and superoinferior (SI) translation was measured in 45° and 90° external rotation with 10 and 15 N loads. Six conditions were tested: intact; SLAP tear (10:00 to 2:00 o'clock); posterior SLAP repair (2 anchors at 10:30 and 11:30); posterior plus anterior SLAP repair (an additional anchor at 1:30); simulated biceps tenodesis with SLAP repair; and simulated biceps tenodesis without SLAP repair. Repeated measures analysis of variance with Tukey post hoc test was used for statistical analysis.

Results: There were no significant differences with SLAP tear or repair in AP/SI translation or range of motion compared with intact. Both simulated tenodesis conditions increased max external rotation compared with intact (P < .006). Simulated tenodesis with SLAP repair significantly increased AP (6/8 positions) and SI translation (2/8 positions) compared with intact. Simulated tenodesis without SLAP repair significantly increased AP (all positions) and SI translation (3/8 positions) compared with intact.

Conclusions: The long head of the biceps has a pertinent biomechanical role in glenohumeral stability regardless of the condition of the superior labrum. The addition of an anterior anchor for SLAP repair did not restrict external rotation in this cadaveric model.

Clinical relevance: The potential contribution of the biceps to biomechanical stability should be a consideration when treating biceps pathology.

肱二头肌肌腱固定术/肌腱切断术在上唇前后撕裂和修复中破坏肱骨关节的生物力学稳定性。
目的:本研究的目的是比较上唇前后(SLAP)撕裂前后肩关节的生物力学稳定性:(1)后路SLAP修复,(2)后路+前路SLAP修复,(3)二头肌肌腱固定术合并SLAP修复,(4)二头肌肌腱固定术不进行SLAP修复。方法:采用自定义检测系统对8具尸体肩部进行检测。施加22 N肩关节压缩力和5N肱二头肌负荷。所有测试均在盂肱外展30°和60°时进行。以2.2 Nm扭矩测量肱骨旋转运动范围。在45°和90°外旋(ER)和10和15 N载荷下测量肱骨前后(AP)和上下(SI)平移。测试了六种情况:完好无损;SLAP撕(10:00 - 2:00);后路SLAP修复(10:30和11:30两次锚定);后路+前路SLAP修复术(1:30额外锚定);模拟二头肌肌腱固定术与SLAP修复术;模拟二头肌肌腱固定术无SLAP修复。采用重复测量方差分析和Tukey事后检验进行统计分析。结果:与完整组相比,SLAP撕裂或修复组在AP/SI平移或活动范围方面无显著差异。两种模拟肌腱固定术条件下的最大ER值均比完整情况下增加(结论:二头肌长头在肩关节稳定性中具有相关的生物力学作用,而与上唇的情况无关。在该尸体模型中,添加前锚钉进行SLAP修复并未限制外旋。临床相关性:在治疗肱二头肌病理时,应考虑肱二头肌对生物力学稳定性的潜在贡献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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