腱板広範囲断裂症例の上腕二頭筋長頭腱の評価

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Background: One of the complications of rotator cuff tears is abnormality or injury of the long head of biceps tendon (LHB). The purpose of this study was to investigate the condition of LHB in massive rotator cuff tears after modified Debeyre-Patte procedure. Methods: The study included 19 patients (20 shoulders) after modified Debeyre-Patte procedure from 2008 to 2010, 12 males and 7 females with an average age of 66.1(56-71) years old. The mean follow-up period was 14.8 (3-36) months. The conditions of LHB were examined at preoperative stage of rotator cuff tears and postoperative stage at a proximal muscular slice in the axial plane on magnetic resonance imaging (MRI). We investigated arthroscopic findings of the shape and condition of LHB at operative period. Results: At the pre-operative / post-operative stage, normal were 6/11 shoulders, dislocation were 6/0, sublaxation were 5/1, absence were 4/5, effusion at groove were 10/5 respectively. We confirmed 4 normal LHB, 12 abnormal LHB with hypertrophy or depressed and/or partial rupture, and 4 completely ruptured LHB. We performed 1 tendon fixation, 1 trimming, and 1 cutting. The complete ruptures of LHB were found in 4 of the 10 shoulders with subscapularis tear. Conclusion: The dislocation of LHB improved in the post operative period. We concluded that the improvement of LHB condition after the repair of massive rotator cuff tear resulted from normal LHB sliding by the reduction of dislocation and improvement of superior migration of the humeral head.

腱板広範囲断裂症例の上腕二頭筋長頭腱の評価

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