Abstract: BACKGROUND: For young patients with proximal lesions of long head of biceps tendons with high requirements for upper limb movement, the commonly tendon fixation includes interface extrusion screw fixation and suture anchor ligation fixation. At present, there are few clinical reports and no conclusion on the comparison of the clinical efficacy of the two.
OBJECTIVE: To compare the clinical efficacy of proximal lesions of long head of biceps tendons by interface extrusion screw fixation and suture anchor ligation fixation in arthroscopy. 
METHODS: Totally 52 patients with proximal lesions of long head of biceps tendons treated in Nanchang Hongdu Hospital of TCM from January 2019 to December 2020 were enrolled and randomly divided into interface extrusion screw group (n=29) and suture screw group (n=23). The patients in both groups were subjected to interface extrusion screw fixation and suture anchor ligation fixation in arthroscopy, respectively. Before, 1, 3, 6, and 12 months after operation, and during last follow-up, shoulder visual analog scale score, the American shoulder and elbow surgeons score, and range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° were compared between the two groups. Elbow flexion muscle strength, reoperation rate and complication rate (Popeye sign) were compared between the two groups at the last follow-up.
RESULTS AND CONCLUSION: The visual analog scale scores, the American shoulder and elbow surgeons score and shoulder range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° were significantly improved after operation compared with those before operation in both groups (P < 0.05). There were no significant differences in visual analog scale scores, the American shoulder and elbow surgeons score and shoulder range of motion in anterior flexion of shoulder and internal and external rotation at elbow flexion 90° between the two groups before and at various time points after operation (P > 0.05). At the last follow-up, the elbow flexion muscle strength of the two groups reached above grade IV, and the results showed no significant difference. Popeye syndrome occurred in the interface extrusion screw group (14%) and reoperation was performed (7%). In the suture screw group, the incidence of Popeye sign was 4.3% and the reoperation rate was 0%. The incidence of Popeye sign and the reoperation rate were not significantly different between the two groups (P > 0.05). For the proximal lesion of long head of biceps tendons, both the interface extrusion screw fixation and the suture anchor ligation fixation in the arthroscopy can effectively relieve shoulder pain and improve shoulder function within one year and the clinical effects of the two methods are equivalent.

Key words: shoulder arthroscopy, long head of biceps tendons, rotator cuff tear, interface extrusion screw, suture anchor, internal fixation