Verma Nikhil N, Dunn Warren, Adler Ronald S, Cordasco Frank A, Allen Answorth, MacGillivray John, Craig Edward, Warren Russell F, Altchek David W
Department of Orthopaedic Surgery, The Hospital for Special Surgery, Cornell University School of Medicine, New York, New York, USA.
Arthroscopy. 2006 Jun;22(6):587-94. doi: 10.1016/j.arthro.2006.01.019.
To compare the clinical outcomes of patients undergoing all-arthroscopic versus mini-open rotator cuff repair. In addition, ultrasound was used to assess the integrity of the repair.
A total of 38 patients who had undergone all-arthroscopic repair and 33 patients who had undergone mini-open repair with minimum 2-year follow-up were evaluated. All patients completed the American Shoulder and Elbow Surgeons' Scoring Survey (ASES), the Simple Shoulder Test, the L'Insalata Scoring Survey, and visual analog scales for pain. Physical examination, including strength testing and ultrasound evaluation to determine the integrity of the rotator cuff, was performed.
No statistical difference in ASES scores was noted between patients who had all-arthroscopic repair versus mini-open repair, and 24% of all-arthroscopic repairs and 27% of mini-open repairs showed recurrent defects on ultrasound at follow-up. This difference was not statistically significant. Patients with an original tear larger than 3 cm were 7 times more likely to have a recurrent defect at follow-up. Patients with persistent defects had statistically significant deficits in strength on forward elevation and external rotation when compared with those with a normal shoulder. However, no difference was observed with regard to pain or outcome scores between patients with intact repairs and those with persistent defects.
No difference in clinical outcomes was found between patients with rotator cuffs repaired arthroscopically and those repaired with use of a mini-open technique.
Level III, retrospective comparative study.
比较全关节镜下与小切口修复肩袖的临床疗效。此外，使用超声评估修复的完整性。
对38例行全关节镜修复和33例行小切口修复且随访至少2年的患者进行评估。所有患者均完成美国肩肘外科医师评分量表（ASES）、简易肩关节测试、L'Insalata评分量表及疼痛视觉模拟量表。进行包括力量测试和超声评估肩袖完整性的体格检查。
全关节镜修复组与小切口修复组患者的ASES评分无统计学差异，随访时全关节镜修复组24%及小切口修复组27%的患者超声检查显示有复发性缺损。这种差异无统计学意义。初始撕裂大于3 cm的患者随访时出现复发性缺损的可能性高7倍。与正常肩部患者相比，存在持续性缺损的患者在前屈和外旋力量方面有统计学意义的不足。然而，修复完整的患者与存在持续性缺损的患者在疼痛或疗效评分方面未观察到差异。
关节镜下修复肩袖的患者与采用小切口技术修复的患者临床疗效无差异。
Ⅲ级，回顾性比较研究。
