受伤的头顶投掷运动员二头肌肌腱固定术的适应症缺乏共识：系统回顾和横断面调查

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-06-01 DOI:10.1016/j.asmr.2025.101113

Aaron D. Sciascia Ph.D., A.T.C., P.E.S., S.M.T.C., F.A.S.S.E.T. , W. Jeffrey Grantham M.D. , Austin V. Stone M.D., Ph.D. , Anthony N. Baumann D.P.T. , John D. Kelly IV M.D. , W. Ben Kibler M.D.

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引用次数: 0

摘要

目的探讨伤愈的头顶投掷运动员肱二头肌肌腱固定术的临床应用方法及目前报道的适应症。方法：本研究结合了对有经验的肩关节外科医生的调查，了解他们建立肌腱固定术的适应症的方法，并对报道在头顶投掷运动员中进行二头肌肌腱固定术的研究进行了系统回顾。调查和回顾旨在确定诊断方法，以确定术前和术中因素，以确定二头肌受累作为临床表现的主要组成部分，并试图为临床实践建立共识。结果对249例头顶投掷运动员进行了分析。5项研究描述了病史评估的要素；体检，在2项研究中；在7项研究中进行了高级影像学检查；诊断性关节镜，在8项研究中。调查的119份回复显示了类似的思维过程，包括二头肌肌腱固定术的推理，但该过程的几个方面似乎没有得到当代文献的支持。此外，诊断成分的使用也不一致，超过50%的受访者只选择了9个病史成分中的3个和9个体检成分中的4个。结论调查显示，关于肌腱固定术的适应症存在不完全支持的推理过程，对于病史或体格检查的单个组成部分没有共识。文献回顾显示，对于确定二头肌参与受伤的投掷肩的诊断过程中，哪些要素是不可或缺的，缺乏共识。证据水平：IV级，III级和IV级研究的系统评价和横断面调查。

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Indications for Biceps Tenodesis in Injured Overhead Throwing Athletes Lack Consensus: A Systematic Review and Cross-Sectional Survey

Purpose

To evaluate the current clinical practice methods and the reported indications for biceps tenodesis in injured overhead throwing athletes.

Methods

This study combined a survey of experienced shoulder surgeons regarding their methods of establishing indications for tenodesis surgery with a systematic review of studies that reported performing biceps tenodesis in overhead throwing athletes. Both the survey and review were designed to identify methods of making the diagnosis to delineate the preoperative and intraoperative factors used to establish biceps involvement as a major component of the clinical presentation, as well as to attempt to establish a consensus for clinical practice.

Results

Eleven studies reporting on 249 overhead throwing athletes were analyzed. Elements of the history evaluation were described in 5 studies; physical examination, in 2 studies; advanced imaging, in 7 studies; and diagnostic arthroscopy, in 8 studies. One hundred nineteen responses to the survey showed a similar thought process regarding the reasoning to include biceps tenodesis, but several aspects of the process appeared to not be supported by contemporary literature. Also, there was inconsistent use of diagnostic components, with only 3 of 9 history components and 4 of 9 physical examination components being selected by more than 50% of the respondents.

Conclusions

The survey revealed there was an incompletely supported reasoning process regarding indications for tenodesis and there was no consensus regarding individual components of the history or physical examination. The literature review revealed a lack of consensus regarding which elements of the diagnostic process are integral in establishing biceps involvement in injured throwing shoulders.