Yen-Wei Huang , Pu-Kuang Wang , Shen-Wu Hung , Yu-Pin Chen , Wei-chun Chang , Yi-Jie Kuo , Tai-Yuan Chuang
{"title":"与传统的肱二头肌肌腱切断术相比,关节镜下t型肱二头肌肌腱切断术降低了大力水手畸形的风险","authors":"Yen-Wei Huang , Pu-Kuang Wang , Shen-Wu Hung , Yu-Pin Chen , Wei-chun Chang , Yi-Jie Kuo , Tai-Yuan Chuang","doi":"10.1016/j.asmart.2025.08.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.</div></div><div><h3>Methods</h3><div>Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.</div></div><div><h3>Results</h3><div>Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores (<em>P</em> < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity (<em>P</em> = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C (<em>P</em> = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective comparative study.</div></div>","PeriodicalId":44283,"journal":{"name":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","volume":"42 ","pages":"Pages 47-53"},"PeriodicalIF":1.4000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Arthroscopic T-shaped biceps tenotomy decreased risk of Popeye deformity compared to traditional biceps tenotomy\",\"authors\":\"Yen-Wei Huang , Pu-Kuang Wang , Shen-Wu Hung , Yu-Pin Chen , Wei-chun Chang , Yi-Jie Kuo , Tai-Yuan Chuang\",\"doi\":\"10.1016/j.asmart.2025.08.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.</div></div><div><h3>Methods</h3><div>Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.</div></div><div><h3>Results</h3><div>Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores (<em>P</em> < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity (<em>P</em> = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C (<em>P</em> = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.</div></div><div><h3>Level of evidence</h3><div>Level III, retrospective comparative study.</div></div>\",\"PeriodicalId\":44283,\"journal\":{\"name\":\"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology\",\"volume\":\"42 \",\"pages\":\"Pages 47-53\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2214687325000160\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2214687325000160","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Arthroscopic T-shaped biceps tenotomy decreased risk of Popeye deformity compared to traditional biceps tenotomy
Purpose
This study compared the clinical efficacy of T-shaped biceps tenotomy (release of the long head of the biceps tendon with a portion of the superior labrum) with that of conventional cylinder-shaped biceps tenotomy (without the labrum) in patients with reparable rotator cuff tears and concomitant lesions of the long head of the biceps tendon.
Methods
Among patients who underwent arthroscopic repair of rotator cuff tears and concomitant lesions of the long head of the biceps tendon, 89 patients aged ≥65 years who were treated with T-shaped biceps tenotomy (group T; n = 46) or conventional cylinder-shaped biceps tenotomy (group C; n = 43) were evaluated. The presence of a Popeye deformity, severity of cramping pain, elbow flexion strength, and forearm supination strength were recorded. The anatomic status of the biceps stump was assessed through ultrasonography. Anatomic failure was considered when the biceps tendon was not identified in the intertubercular groove.
Results
Overall, 86 patients (45 in group T and 41 in group C) were monitored for more than 2 years. Their postoperative functional scores were significantly better than their preoperative scores (P < 0.03) and did not differ significantly between the two groups. Three patients (6.7 %) in group T and nine (22.0 %) in group C had a Popeye deformity (P = 0.036). Ultrasonography revealed anatomic failure in five patients (11.1 %) in group T and 13 (31.7 %) in group C (P = 0.021). Postoperative cramping pain and elbow flexion strength were evaluated, showing no significant differences between groups.
Conclusions
For treating concomitant LHBT lesions in patients with rotator cuff tears, T-shaped tenotomy involving a portion of the superior labrum is an acceptable alternative to conventional cylinder-shaped tenotomy not involving the labrum. T-shaped tenotomy is associated with similar functional outcome and lower occurrence rates of a postoperative Popeye deformity than conventional cylinder-shaped tenotomy.
期刊介绍:
The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.