الفهرس | Only 14 pages are availabe for public view |
Abstract The recognition and treatment of biceps lesions associated with rotator cuff disease has resulted in better patient outcomes. It is now appreciated that biceps tendon pathology is an important “pain generator” and that ignoring the biceps tendon may compromise the clinical outcome of treatment. The aim of this study was to conduct a systematic review and meta-analysis to compare the effectiveness of tenodesis and tenotomy in treatment of LHBT lesions with repairable rotator cuff tears . The endpoint was post-operative differences in Constant and ASES scores between the 2 groups at final follow-up. The secondary end point was evaluation of pain as quantified by visual analogue scale (VAS). Arthroscopic rotator cuff repair with subpectoral biceps tenodesis showed better clinical outcome than tenotomy procedure in young patients. However there was no statistically significant difference in clinical outcome between the two groups in the included studies . Both tenotomy and tenodesis are effective and comparable for the treatment of LHB lesions. However, because tenotomy requires a shorter surgical time and results in faster pain relief, tenotomy may be more suitable for the treatment of LHB lesions in patients older than 50 years of age with reparable rotator cuff tears. Tenotomy and tenodesis are good ways to treat LHBT lesions with concomitant RCTS. However we should consider tenodesis of LHBT for young people who has LHBT lesions because its result regarding muscle power of shoulder is significantly improved more than who did tenotomy. Also, It is recommended tenodesis rather than tenotomy for LHBT lesions in atheltic people depending on the results of meta- analysis which showed increased postoperative rate of pop eye deformity in people who did tenotomy more than who did tenodesis . Finally , further high-level evidence prospective clinical trial researchs are needed to determine the best modality to treat LHBT lesions and to evalute the advantages and disadvantages of tenotomy and tenodesis precisely . |