Reilly Peter, Bull Anthony M J, Amis Andrew A, Wallace Andrew L, Richards Andrew, Hill Adam M, Emery Roger J H
St Mary's Hospital, London, UK.
J Shoulder Elbow Surg. 2004 Nov-Dec;13(6):664-7. doi: 10.1016/j.jse.2004.03.011.
The objectives of this study were to quantify the relationship between passive tension of rotator cuff repairs and arm position and to examine the effect of this tension on repair gap formation. Five patients undergoing open surgical rotator cuff repair of the supraspinatus tendon were recruited. Tendon tension was recorded as the supraspinatus was advanced into a bone trough and secured. The relationship between arm position and repair tension was then measured. Standardized rotator cuff tears were created in 3 cadaveric shoulders and repaired by use of the intraoperative technique. The difference in tension measured between 0 degrees and 30 degrees abduction was statically applied for 24 hours and the gap formation measured. Repair tension increased with advancement of the supraspinatus tendon into the bone trough. Abduction reduced the repair load. The mean reduction in load by 30 degrees abduction was 34 N. Twenty-four hours of 34-N loading caused gap formation of 9 mm in cadaveric rotator cuff repairs. Passive tension in surgically repaired rotator cuffs may contribute to repair failure and can be modified by arm positioning.
本研究的目的是量化肩袖修复的被动张力与手臂位置之间的关系，并研究这种张力对修复间隙形成的影响。招募了5例接受开放性手术修复冈上肌腱肩袖的患者。在将冈上肌推进骨槽并固定时记录肌腱张力。然后测量手臂位置与修复张力之间的关系。在3具尸体肩部制造标准化的肩袖撕裂，并采用术中技术进行修复。将外展0度和30度之间测量的张力差异静态施加24小时，并测量间隙形成情况。随着冈上肌腱推进到骨槽中，修复张力增加。外展减少了修复负荷。外展30度时负荷的平均减少量为34 N。在尸体肩袖修复中，24小时施加34 N的负荷导致形成9 mm的间隙。手术修复的肩袖中的被动张力可能导致修复失败，并且可以通过手臂定位来改变。
