Cormier Grégoire, Berthelot Jean-Marie, Maugars Yves
Rheumatology Department, Nantes Teaching Hospital, 44093 Nantes cedex 1, France.
Joint Bone Spine. 2006 Jul;73(4):411-3. doi: 10.1016/j.jbspin.2006.01.021. Epub 2006 May 11.
To obtain information on the diagnosis and surgical treatment of hip rotator cuff tears by French orthopedic surgeons.
Survey conducted in 2003 by mailing questionnaires to 459 orthopedic surgeons practicing in France.
Of the 84 respondents, 38 (45%) were not aware that tears could occur in the hip rotator cuff and 11 (13%) had never suspected this diagnosis in any of their patients. The 35 (42%) remaining surgeons had experience with at least one case of gluteal tendon repair; among them, 24 (29%) made the diagnosis fortuitously during surgery for another reason (total hip arthroplasty). Only 11 (13%) surgeons had performed surgery to treat gluteal tendon tears that were diagnosed preoperatively (gluteus medius in 20 cases, gluteus maximus in six cases, and gluteus minimus in three cases; total, 29 cases). Of these 29 cases, only 14 were treated by surgical tendon repair (by six [7%] surgeons); the remaining repair procedures were done during total hip arthroplasty. The retrospective data collection procedure and absence of medium-term follow-up data preclude conclusions about the outcomes of surgical treatment.
Gluteal tendon tears may be underrecognized by orthopedic surgeons in France, who may have limited experience with repairing these lesions. Autopsy and imaging studies have shown gluteal tendon tears in up to 10% of individuals older than 60 years.
获取法国骨科医生对髋部旋转袖套撕裂的诊断和手术治疗的相关信息。
2003年通过向在法国执业的459名骨科医生邮寄问卷进行调查。
在84名受访者中，38名（45%）不知道髋部旋转袖套会发生撕裂，11名（13%）在其任何患者中从未怀疑过这种诊断。其余35名（42%）外科医生至少有一例臀肌腱修复经验；其中，24名（29%）是在因其他原因进行手术（全髋关节置换术）时偶然做出诊断的。只有11名（13%）外科医生对术前诊断的臀肌腱撕裂进行了手术治疗（臀中肌20例，臀大肌6例，臀小肌3例；共29例）。在这29例中，只有14例接受了肌腱手术修复（由6名[7%]外科医生进行）；其余修复手术是在全髋关节置换术期间完成的。回顾性数据收集程序以及缺乏中期随访数据使得无法得出关于手术治疗结果的结论。
法国的骨科医生可能对臀肌腱撕裂认识不足，他们修复这些损伤的经验可能有限。尸检和影像学研究表明，在60岁以上的人群中，高达10%的人存在臀肌腱撕裂。
