Background:Tenodesis of the long head of the biceps(LHB)is commonly undertaken during arthroscopic rotator cuff repair.We assessed the clinical and structural outcomes after high arthroscopic tenodesis(HAT)or mini-ope...Background:Tenodesis of the long head of the biceps(LHB)is commonly undertaken during arthroscopic rotator cuff repair.We assessed the clinical and structural outcomes after high arthroscopic tenodesis(HAT)or mini-open subpectoral tenodesis(ST).We hypothesized that the clinical and structural results after HAT and ST are similar.Methods:We included 40 patients with rotator cuff tear and LHB tendinopathy.Twenty patients(7 women and 13 men;mean age:57.9 years;range:56-63 years)were treated using HAT,and 20 patients(8 women and 12 men;mean age:58.5 years;range:55-64 years)were treated using ST.Functional evaluation was performed preoperatively and at 6 weeks,6 months,and 1 year after surgery,using the Constant Murley Score and Simple Shoulder Test scores;the LHB was evaluated using the LHB score.A Visual Analogue Scale was administered to all patients preoperatively and 2 days after surgery.Results:The postoperative total and pain subscale’s Constant scores were significantly higher in the ST group.Moreover,2 LHB score values were significantly different between the groups.The postoperative LHB total score in the ST and HAT groups averaged 86.9±4.1(mean±SD)points and 73.3±6.4 points,respectively.The Pain/Cramps subscale in the ST and HAT groups averaged 47.1±5.9 and 33.2±4.6 points,respectively.The 2 groups showed no difference in Visual Analogue Scale values(5.5 in the HAT group;5.8 in the ST group)postoperatively.One patient in the HAT group reported a secondary onset of Popeye deformity.Conclusion:Both high arthroscopic and mini-open ST of the LHB tendon produced reliably good functional results,but the ST group was associated with better postoperative clinical outcomes.展开更多
Background:When non-operative management fails to improve symptoms in patients with non-insertional Achilles tendinopathy,surgery may be required.Various open and endoscopic techniques have been proposed,and platelet-...Background:When non-operative management fails to improve symptoms in patients with non-insertional Achilles tendinopathy,surgery may be required.Various open and endoscopic techniques have been proposed,and platelet-rich plasma(PRP)injections have been proposed as an adjunct to aid tendon healing.Methods:Thirty-six patients with mid-portion Achilles tendinopathy were randomized to undergo endoscopic debridement alone(n=19)or in combination with intraoperative PRP application(n=17).Clinical outcome measures included the Visual Analogue Scale for pain,function,and satisfaction and the Victorian Institute of Sports Assessment-Achilles(VISA-A)questionnaire.Patients were followed-up at 6 weeks,3months,6 months,and 12 months after surgery.An MRI examination at 3 and 12 months was used to assess signal alterations within the tendon.Results:Both groups showed significant clinical improvement(p<0.05)after surgery,with no difference between the 2 groups.Tendon diameter increased at 3 months and decreased at 12 months.The tendinopathy area increased at 3 months and decreased at 12 months below baseline level in both groups.There was no significant difference between the groups regarding the MRI parameters.Nodular thickening and MRIdetected signal alteration persisted after surgery,with no association between imaging and clinical outcome.Five minor complications were reported:2 in the PRP group and 3 in the control group.Conclusion:Endoscopic debridement of the Achilles tendon improved clinical outcomes in patients with mid-portion tendinopathy.The addition of PRP did not improve outcomes compared to debridement alone.MRI parameters showed no association with clinical outcomes.展开更多
文摘Background:Tenodesis of the long head of the biceps(LHB)is commonly undertaken during arthroscopic rotator cuff repair.We assessed the clinical and structural outcomes after high arthroscopic tenodesis(HAT)or mini-open subpectoral tenodesis(ST).We hypothesized that the clinical and structural results after HAT and ST are similar.Methods:We included 40 patients with rotator cuff tear and LHB tendinopathy.Twenty patients(7 women and 13 men;mean age:57.9 years;range:56-63 years)were treated using HAT,and 20 patients(8 women and 12 men;mean age:58.5 years;range:55-64 years)were treated using ST.Functional evaluation was performed preoperatively and at 6 weeks,6 months,and 1 year after surgery,using the Constant Murley Score and Simple Shoulder Test scores;the LHB was evaluated using the LHB score.A Visual Analogue Scale was administered to all patients preoperatively and 2 days after surgery.Results:The postoperative total and pain subscale’s Constant scores were significantly higher in the ST group.Moreover,2 LHB score values were significantly different between the groups.The postoperative LHB total score in the ST and HAT groups averaged 86.9±4.1(mean±SD)points and 73.3±6.4 points,respectively.The Pain/Cramps subscale in the ST and HAT groups averaged 47.1±5.9 and 33.2±4.6 points,respectively.The 2 groups showed no difference in Visual Analogue Scale values(5.5 in the HAT group;5.8 in the ST group)postoperatively.One patient in the HAT group reported a secondary onset of Popeye deformity.Conclusion:Both high arthroscopic and mini-open ST of the LHB tendon produced reliably good functional results,but the ST group was associated with better postoperative clinical outcomes.
文摘Background:When non-operative management fails to improve symptoms in patients with non-insertional Achilles tendinopathy,surgery may be required.Various open and endoscopic techniques have been proposed,and platelet-rich plasma(PRP)injections have been proposed as an adjunct to aid tendon healing.Methods:Thirty-six patients with mid-portion Achilles tendinopathy were randomized to undergo endoscopic debridement alone(n=19)or in combination with intraoperative PRP application(n=17).Clinical outcome measures included the Visual Analogue Scale for pain,function,and satisfaction and the Victorian Institute of Sports Assessment-Achilles(VISA-A)questionnaire.Patients were followed-up at 6 weeks,3months,6 months,and 12 months after surgery.An MRI examination at 3 and 12 months was used to assess signal alterations within the tendon.Results:Both groups showed significant clinical improvement(p<0.05)after surgery,with no difference between the 2 groups.Tendon diameter increased at 3 months and decreased at 12 months.The tendinopathy area increased at 3 months and decreased at 12 months below baseline level in both groups.There was no significant difference between the groups regarding the MRI parameters.Nodular thickening and MRIdetected signal alteration persisted after surgery,with no association between imaging and clinical outcome.Five minor complications were reported:2 in the PRP group and 3 in the control group.Conclusion:Endoscopic debridement of the Achilles tendon improved clinical outcomes in patients with mid-portion tendinopathy.The addition of PRP did not improve outcomes compared to debridement alone.MRI parameters showed no association with clinical outcomes.
