Burkhart S S
Department of Orthopaedic Surgery, Baylor College of Medicine, and University of Texas Health Science Center at San Antonio, USA.
Clin Orthop Relat Res. 2001 Sep(390):107-18. doi: 10.1097/00003086-200109000-00013.
In the past 10 years, arthroscopic surgeons have gone from being unable to repair any rotator cuff tears arthroscopically to being able to repair virtually all rotator cuff tears, even complex massive tears, arthroscopically. The factors responsible for this rapid evolution have been: (1) recognition of the mechanical principles responsible for a secure repair (margin convergence, knot security, loop security); (2) recognition of major tear patterns that require different techniques of repair; and (3) development of instrumentation and arthroscopic portals that predictably accomplish secure repair of the rotator cuff and direct access to the pathologic areas. In the current study, the author analyzes each factor, anatomic and mechanical, that influences the quality of the repair, and explains how to optimize the overall repair by optimizing each step in the repair. In the author's series of arthroscopic repair of rotator cuff tears, the results have been gratifying, with massive tears achieving final results equivalent to those of smaller tears.
在过去10年里，关节镜外科医生已经从无法通过关节镜修复任何肩袖撕裂，发展到几乎能够通过关节镜修复所有肩袖撕裂，甚至是复杂的巨大撕裂。促成这一快速发展的因素包括：（1）认识到实现牢固修复的力学原理（边缘汇聚、结的稳固性、环的稳固性）；（2）认识到需要不同修复技术的主要撕裂模式；（3）开发出能够可预测地实现肩袖牢固修复并直接进入病变区域的器械和关节镜入路。在本研究中，作者分析了影响修复质量的每个解剖学和力学因素，并解释了如何通过优化修复中的每一步来优化整体修复。在作者的一系列肩袖撕裂关节镜修复病例中，结果令人满意，巨大撕裂的最终效果与较小撕裂的效果相当。
