Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Clinical Results of Arthroscopic Biceps Long Head Tenodesis Above the Pectoralis Major Using an Interference Screw

간섭나사를 이용한 관절경적 상완 이두건 대흉근 상부 건 고정술의 임상적 결과

  • Choi, Sang Su (Department of Orthopaedic Surgery, Wonkwang University School of Medicine) ;
  • Kang, Hong Je (Department of Orthopaedic Surgery, Wonkwang University School of Medicine) ;
  • Kim, Jeong Woo (Department of Orthopaedic Surgery, Wonkwang University School of Medicine) ;
  • Kim, Jong Yun (Department of Orthopedic Surgery, Gunsan Medical Center) ;
  • Kim, Dong Moon (Department of Social Physical Education, Wonkwang University) ;
  • Kim, Kwang Mee (Department of Nursing Science, Chodang University Muan)
  • 최상수 (원광대학교 의과대학 정형외과학교실) ;
  • 강홍제 (원광대학교 의과대학 정형외과학교실) ;
  • 김정우 (원광대학교 의과대학 정형외과학교실) ;
  • 김종윤 (군산의료원 정형외과) ;
  • 김동문 (원광대학교 사회체육학과) ;
  • 김광미 (초당대학교 간호학교실)
  • Received : 2013.06.12
  • Accepted : 2013.08.28
  • Published : 2013.12.31
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Abstract

Purpose: The purpose of this study is to evaluate the clinical results of arthroscopic biceps long head suprapectoral tenodesis using an interference screw. Materials and Methods: We reviewed the cases of 30 patients who underwent arthroscopic biceps long head suprapectoral tenodesis using an interference screw between January 2008 and January 2010. The minimum follow up period was one year. Twenty patients had rotator cuff tears. The results were analyzed by VAS, ASES, tenderness in the bicipital groove, fixation failure, and the degree of deformity. Results: VAS, ASES scores showed a statistically significant increase during the final observation in all patients, compared with those before surgery. However, five patients (17%) had anterior shoulder pain and tenderness in the biceps groove, and three patients (10%) had Popeye deformity. Better results were achieved in patients without rotator cuff tear than in patients with rotator cuff tear (p<0.05). Conclusion: Arthroscopic biceps long head tenodesis above the pectoralis major using an interference screw in patients with a pathologic lesion of the proximal biceps tendon showed good results at the last follow up. However, further study for tenderness in the biceps groove in 17% of patients is needed.

목적: 간섭나사(interference screw)를 이용한 관절경적 상완 이두건 대흉근 상부 건 고정술의 임상적 결과를 분석하고자 하였다. 대상 및 방법: 2008년 1월부터 2010년 1월까지 간섭나사를 이용한 관절경적 상완 이두건 장두의 대흉근 상부 건 고정술을 시행한 환자를 대상으로 하였고, 이 중 최소 1년 이상 추시 가능하였던 30예를 대상으로 하였다. 그 중 회전근 개 파열을 동반한 경우는 20예였다. 결과는 VAS, ASES, 상완 이두건 구의 통증, 고정실패 및 변형 정도로 판단하였다. 결과: 최종 추시에서 모든 환자에서 수술 전에 비해 VAS, ASES점수는 의미 있게 호전되었으나(p<0.05), 5예(17%)에서 견관절 전방 통증 및 상완 이두건 구의 압통이 존재하였고, 3예(10%)에서 고정실패로 인한 Popeye 변형이 존재하였다. 또한, 회전근 개 파열을 동반하지 않는 군에서 파열을 동반한 군보다 좋은 결과를 얻을 수 있었다(p<0.05). 결론: 상완 이두건 근위부 병변에 의한 통증이 있는 환자에서 간섭나사를 이용한 관절경적 상완 이두건 장두의 대흉근 상부 건 고정술은 좋은 결과를 얻을 수 있어 유용한 치료방법으로 사료되나, 17%에서 상완 이두건구에 압통이 존재해 이에 대한 추가적 연구가 필요할 것으로 사료된다.

Keywords

References

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