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使用生物可吸收钉进行关节镜下全层肩袖撕裂修补术。

Arthroscopic repair of full-thickness rotator cuff tears using bioabsorbable tacks.

作者信息

McBirnie Julie M, Miniaci Anthony, Miniaci Sara Lyn

机构信息

Department of Orthopaedic Surgery, The Royal Infirmary of Edinburgh, Edinburgh, Scotland.

出版信息

Arthroscopy. 2005 Dec;21(12):1421-7. doi: 10.1016/j.arthro.2005.09.017.

Abstract

PURPOSE

The purpose of this study was to evaluate the clinical results of bioabsorbable tacks (Suretac; Smith & Nephew Endoscopy, Mansfield, MA) for the arthroscopic repair of full-thickness rotator cuff tears.

TYPE OF STUDY

Prospective case series.

METHODS

A prospective clinical review was performed on 53 patients (38 men, 15 women) with full-thickness rotator cuff tears repaired arthroscopically using bioabsorbable tacks. Minimum follow-up was 24 months and patients were evaluated using preoperative and postoperative American Shoulder and Elbow Society (ASES) scores and Short-Form 36 Health Surveys (SF-36). A Constant and Murley score was performed at a minimum of 2 years postoperatively.

RESULTS

The average patient age was 51 years (range, 23 to 74 years) and the average time for review was 29 months (range, 24 to 60 months). The average size of rotator cuff tears measured 2.5 cm (range, 1 to 5 cm) and an average of 2 Suretacs (range, 1 to 4) were used for the repair. Ten patients had tears larger than 3 cm and 5 patients had tears that measured 5 cm or larger. The average total score according to the ASES shoulder index improved from 33 to 85 points. The average score for pain improved from 6.9 to 1.3 points. The score for function improved from 11 to 25 points. These results were statistically significant (P < 0.01). There was a significant improvement in all components of the SF-36 survey. The average postoperative Constant score was 87 with the pain component measuring 12 points, range of movement 38 points, and power 21 points.

CONCLUSIONS

Arthroscopic repair of full-thickness rotator cuff tears using bioabsorbable tacks produces satisfactory outcomes with regard to objective orthopaedic criteria as well as overall patient satisfaction in terms of pain relief and function. Arthroscopic rotator cuff repairs are technically demanding procedures. The use of tacks facilitates this procedure without any apparent deterioration in clinical results.

LEVEL OF EVIDENCE

Level IV, case series.

摘要

目的

本研究旨在评估生物可吸收钉(Suretac;施乐辉内窥镜公司,马萨诸塞州曼斯菲尔德)用于关节镜下修复全层肩袖撕裂的临床效果。

研究类型

前瞻性病例系列研究。

方法

对53例(38例男性,15例女性)接受关节镜下使用生物可吸收钉修复全层肩袖撕裂的患者进行前瞻性临床回顾。最短随访时间为24个月,采用术前和术后美国肩肘协会(ASES)评分及简短健康调查问卷(SF-36)对患者进行评估。术后至少2年进行Constant和Murley评分。

结果

患者平均年龄为51岁(范围23至74岁),平均复查时间为29个月(范围24至60个月)。肩袖撕裂平均大小为2.5 cm(范围1至5 cm),平均使用2枚生物可吸收钉(范围1至4枚)进行修复。10例患者撕裂大于3 cm,5例患者撕裂为5 cm或更大。根据ASES肩部指数,平均总分从33分提高到85分。疼痛平均评分从6.9分提高到1.3分。功能评分从11分提高到25分。这些结果具有统计学意义(P < 0.01)。SF-36调查的所有项目均有显著改善。术后Constant平均评分为87分,其中疼痛部分为12分,活动范围为38分,力量为21分。

结论

使用生物可吸收钉进行关节镜下全层肩袖撕裂修复,在客观骨科标准以及患者在疼痛缓解和功能方面的总体满意度方面均产生了令人满意的结果。关节镜下肩袖修复是技术要求较高的手术。使用钉子有助于该手术,且临床效果无明显恶化。

证据水平

IV级,病例系列。

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