Background:

Biceps tenodesis has been suggested as a superior surgical technique compared with isolated labral repair for superior labral anterior-posterior (SLAP) tears in patients older than 35 years. The superiority of this procedure in younger patients, however, is yet to be determined.

Purpose:

To compare the outcomes of arthroscopic SLAP repair with those of arthroscopic-assisted subpectoral biceps tenodesis for type II SLAP tears in active-duty military patients younger than 35 years.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Preoperative and postoperative evaluations with a minimum 5-year follow-up including the visual analog scale (VAS), the Single Assessment Numeric Evaluation (SANE), and the American Shoulder and Elbow Surgeons (ASES) shoulder score were administered, and scores were compared between 2 groups of patients younger than 35 years. One group included 25 patients who underwent SLAP repair, and the second group included 23 patients who underwent arthroscopic-assisted subpectoral biceps tenodesis.

Results:

The preoperative patient age (P = .3639), forward flexion (P = .8214), external rotation (P = .5134), VAS pain score (P = .4487), SANE score (P = .6614), and ASES score (P = .6519) did not vary significantly between the 2 study groups. Both groups demonstrated statistically significant increases in function as measured by the ASES and SANE and decreases in pain as measured by the VAS at a minimum of 5 years postoperatively. Also at a minimum of 5 years postoperatively, patients in the tenodesis group had lower pain (1.3 vs 2.6, respectively; P = .0358) and higher SANE (84.0 vs 63.3, respectively; P = .0001) and ASES (85.7 vs 75.4, respectively; P = .0342) scores compared with those in the repair group. Failure rate was 20.0% in the repair group versus 0.0% in the tenodesis group (P = .0234).

Conclusion:

Active-duty military patients younger than 35 years with type II SLAP tears had more predictable improvement in pain, better functional outcomes, and lower failure rates after biceps tenodesis compared with SLAP repair for type II SLAP tears. Overall, the results of this study indicate that arthroscopic- assisted subpectoral biceps tenodesis is superior to arthroscopic SLAP repair for the treatment of type II SLAP tears in military patients younger than 35 years.

中文翻译：

---

肱二头肌肌腱固定术是 35 岁以下现役军人患者 II 型 SLAP 损伤的一种有吸引力的替代方法

背景：

对于 35 岁以上的患者，肱二头肌肌腱固定术被认为是一种优于单纯盂唇修复术的手术技术，可用于治疗 35 岁以上的上唇前-后 (SLAP) 撕裂。然而，这种手术在年轻患者中的优越性尚待确定。

目的：

比较关节镜下 SLAP 修复与关节镜下胸下二头肌肌腱固定术治疗 35 岁以下现役军人 II 型 SLAP 撕裂的结果。

学习规划：

队列研究；证据水平，3。

方法：

进行术前和术后至少 5 年随访的评估，包括视觉模拟量表 (VAS)、单一评估数值评估 (SANE) 和美国肩肘外科医生 (ASES) 肩部评分，并比较评分在 2 组年龄小于 35 岁的患者之间。一组包括 25 名接受 SLAP 修复的患者，第二组包括 23 名接受关节镜辅助胸下肱二头肌肌腱固定术的患者。

结果：

术前患者年龄 ( P = .3639)、前屈 ( P = .8214)、外旋 ( P = .5134)、VAS 疼痛评分 ( P = .4487)、SANE 评分 ( P = .6614) 和 ASES两个研究组之间的得分 ( P = .6519) 没有显着差异。在术后至少 5 年，两组均显示出通过 ASES 和 SANE 测量的功能有统计学意义的增加，以及通过 VAS 测量的疼痛减少。同样在术后至少 5 年，肌腱固定组患者的疼痛程度较低（分别为 1.3 和 2.6；P = .0358）和更高的 SANE（分别为 84.0 和 63.3；P= .0001）和ASES（分别为85.7 vs 75.4；P = .0342）与修复组相比。修复组的失败率为 20.0%，而肌腱固定组的失败率为 0.0% ( P = .0234)。

结论：

与 SLAP 修复 II 型 SLAP 撕裂相比，2 型 SLAP 撕裂的 35 岁以下现役军人在二头肌肌腱固定术后疼痛改善更可预测，功能结果更好，失败率更低。总体而言，这项研究的结果表明，对于 35 岁以下军人的 II 型 SLAP 撕裂，关节镜辅助胸下二头肌肌腱固定术优于关节镜 SLAP 修复术。