Clinical Study Of Two Kinds Of Long Head Tendon Fixation Of Biceps Brachii

Background: Open subpectoral biceps tenodesis(OSPBT)and arthroscopic suprapectoral biceps tenodesis(ASPBT)have become competitive strategies for the treatment of long head of the biceps(LHB)lesions.At present,there is controversy over which of the two fixation methods has more clinical effects.Methods: From 2016 to 2018,patients receiving OSPBT or ASPBT in the department of orthopaedics of the second affiliated hospital of Nanchang university were included in the study.Demographic data of patients with complications and concurrent shoulder surgery were recorded.Patients were hospitalized for 5-7 days after surgery and followed up for 3-6 months.We separately compared the VAS(Visual Analogue Scale)score and Constant score and ASES(American shoulder and elbow surgery)score and satisfaction at the final follow-up of patients in the two groups.In addition,we compared the VAS scores and satisfaction of the two groups of patients at discharge.Finally,postoperative complications were observed,such as infection,nonunion,loosening of fixation,postoperative persistent pain,and joint stiffness.Results: A total of 55 patients were included in the study and 5 patients were not followed up.Finally,a total of 50 patients(23 in the OSPBT group and 27 in the ASPBT group)were included in the study.Among the 50 patients,1 patient in the ASPBT group had postoperative persistent pain,which was relieved after 3 months of treatment.Delayed wound healing occurred in 1 case of the OSPBT group,and no other complications occurred in the remaining patients after active dressing change.At discharge,VAS scores of patients in the two groups were :ASPBT group 1.48±1.01,OSPBT group 2.17±0.71,P =0.009.Satisfaction at discharge was 92.6% in ASPBT group and 82.9% in OSPBT group.In the final follow-up,the two groups of ASES scores were as follows: ASPBT group 85.4±3.9,OSPBT group 85.2±3.0,P=0.823;The Constant scores were: 84.6±3.0 in ASPBT group and 84.9±3.7 in OSPBT group,P =0.763;VAS score was 0.39±0.49 in ASPBT group and 0.37±0.49 in OSPBT group,P =0.882;The satisfaction was 96.3% in ASPBT group and 95.6% in OSPBT group.Conclusion: After statistical analysis,the VAS score of patients in ASPBT group was low and statistically significant at discharge.Other indicators were not statistically significant.We believe that ASPBT group can bring patients faster pain recovery and better medical experience when patients seek medical treatment,so the clinical effect of ASPBT is better than OSPBT.