Treatment of pathology of the tendon of the long head of the biceps muscle of the shoulder in patients with concomitant damage to the rotator cuff of the shoulder joint

   Introduction: The shoulder joint has an anatomical predisposition to damage to the tendons of the rotator cuff and damage to the tendon of the long head of the biceps (LHB). A combination of several diseases is also possible. It is worth noting that isolated pathology of the LHB occurs infrequently. In most cases, it is combined with damage to the tendons of the rotator cuff.

   We study the results of treatment of patients with pathology LHB in combination with damage to the rotator cuff.

   Methods: A prospective analysis of the results of surgical treatment of 115 patients with pathology the LHB with concomitant damage to the supraspinatus tendon (SSP) and the subscapularis tendon (SSC) aged 18 to 79 years was carried out. All patients underwent surgical treatment – arthroscopic suture of the rotator cuff in combination with tenotomy or tenodesis LHB. The influence of factors was analyzed: the gender and age of the patient, the fact of injury or degenerative processes, the level of physical activity, the timing before surgery, the specifics of rehabilitation. The functional results of treatment were evaluated using questionnaires: the Visual-Analog Scale (VAS), the American Shoulder and Elbow Score (ASES) questionnaire, the Single Assessment Numerical Evaluation (SANE) questionnaire, and the Return to Activity Scale (VA).

   Results: as a result of surgical treatment of 115 patients, the majority of patients (97.4 %) noted the overall high efficiency of the performed intervention, including 16/115 people (13.9 %) noted sufficient effectiveness, 3/115 (2.6 %) were dissatisfied with the results. In the overall structure of positive results of surgical treatment in the "tenodesis" group (TD), according to ASES, it was 92.29 - 11,174, in the "tenotomy" group (TT) – 93.79 - 7,769. According to YOUR - 8.7 mm - 1,812 mm in and 6.1 mm - 1,187 mm. The return to the previous activity level of 1.78 - 0.502 points in the "TT" group and 1.83 - 0.425 points - "TD", which indicates the high efficiency of the surgical treatment. It was also revealed that the patient's gender, age, the presence of injury or degenerative changes, the level of physical activity of the patient do not affect the outcome of the final treatment.

   Conclusion: in the treatment of patients with damage to the end, it is advisable to perform a tenodesis procedure. Tenodesis can be performed in the proximal parts of the inter-tubercular furrow with the help of a nodal anchor retainer with a single-stage seam of the rotator cuff. At the same time, it is also important to pay great importance to the rehabilitation of the patient.

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