Sugaya Hiroyuki, Maeda Kazuhiko, Matsuki Keisuke, Moriishi Joji
Shoulder and Elbow Service, Funabashi Orthopedic Sports Medicine Center, Funabashi, Chiba, Japan.
Arthroscopy. 2005 Nov;21(11):1307-16. doi: 10.1016/j.arthro.2005.08.011.
The purpose of this study was to compare the functional as well as the structural outcomes of single-row and dual-row fixation after arthroscopic full-thickness rotator cuff repair.
Retrospective cohort study.
A consecutive series of 80 shoulders in 78 patients with full-thickness rotator cuff tears was evaluated using the rating scale of the University of California Los Angeles (UCLA) and the shoulder index of the American Shoulder and Elbow Surgeons (ASES) at an average of 35 months (range, 24 to 60 months) after arthroscopic rotator cuff repair. Thirty-nine shoulders were repaired using the single-row technique and 41 shoulders using the dual-row technique. Postoperative cuff integrity was determined through magnetic resonance imaging and was classified into 5 categories: type I, sufficient thickness with homogenously low intensity; type II, sufficient thickness with partial high intensity; type III, insufficient thickness without discontinuity; type IV, presence of a minor discontinuity; type V, presence of a major discontinuity.
The average UCLA score improved significantly to 32.4 in the single-row and to 33.1 in the dual-row group. The ASES shoulder index improved significantly to 93.0 in the single-row group and to 94.6 in the dual-row group. However, there was no statistical difference between the groups in the postoperative scores. Postoperative MRI revealed 11 type I, 6 type II, 12 type III, 4 type IV, and 6 type V in the single-row group, and 22 type I, 8 type II, 7 type III, 4 type IV, and no type V in the dual-row group. A statistical difference was observed between the groups (P < .01).
Arthroscopic rotator cuff repair yielded successful functional outcomes without significant difference between single and dual-row fixation techniques. However, dual-row repairs excelled in structural outcome over the single-row technique.
Level III.
本研究旨在比较关节镜下全层肩袖修复术后单排和双排固定的功能及结构结果。
回顾性队列研究。
对78例全层肩袖撕裂患者的80个肩关节进行连续评估，在关节镜下肩袖修复术后平均35个月（范围24至60个月）时，使用加利福尼亚大学洛杉矶分校（UCLA）评分量表和美国肩肘外科医师学会（ASES）肩关节指数进行评估。39个肩关节采用单排技术修复，41个肩关节采用双排技术修复。术后通过磁共振成像确定肩袖完整性，并分为5类：I型，厚度足够且强度均匀低；II型，厚度足够但部分强度高；III型，厚度不足但无连续性中断；IV型，存在轻微连续性中断；V型，存在严重连续性中断。
单排组的平均UCLA评分显著提高到32.4，双排组提高到33.1。单排组的ASES肩关节指数显著提高到93.0，双排组提高到94.6。然而，两组术后评分无统计学差异。术后MRI显示单排组有11例I型、6例II型、12例III型、4例IV型和6例V型，双排组有22例I型、8例II型、7例III型、4例IV型且无V型。两组间观察到统计学差异（P < .01）。
关节镜下肩袖修复取得了成功的功能结果，单排和双排固定技术之间无显著差异。然而，双排修复在结构结果上优于单排技术。
III级。
