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关节镜下单排与双排缝线锚钉修复肩袖撕裂的等效临床结果:一项随机对照试验

Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial.

作者信息

Franceschi Francesco, Ruzzini Laura, Longo Umile Giuseppe, Martina Francesca Maria, Zobel Bruno Beomonte, Maffulli Nicola, Denaro Vincenzo

机构信息

Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Longoni, 83 Rome, Italy.

出版信息

Am J Sports Med. 2007 Aug;35(8):1254-60. doi: 10.1177/0363546507302218. Epub 2007 Jun 6.

Abstract

BACKGROUND

Restoring the anatomical footprint may improve the healing and mechanical strength of repaired tendons. A double row of suture anchors increases the tendon-bone contact area, reconstituting a more anatomical configuration of the rotator cuff footprint.

HYPOTHESIS

There is no difference in clinical and imaging outcome between single-row and double-row suture anchor technique repairs of rotator cuff tears.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

The authors recruited 60 patients. In 30 patients, rotator cuff repair was performed with a single-row suture anchor technique (group 1). In the other 30 patients, rotator cuff repair was performed with a double-row suture anchor technique (group 2).

RESULTS

Eight patients (4 in the single-row anchor repair group and 4 in the double-row anchor repair group) did not return at the final follow-up. At the 2-year follow-up, no statistically significant differences were seen with respect to the University of California, Los Angeles score and range of motion values. At 2-year follow-up, postoperative magnetic resonance arthrography in group 1 showed intact tendons in 14 patients, partial-thickness defects in 10 patients, and full-thickness defects in 2 patients. In group 2, magnetic resonance arthrography showed an intact rotator cuff in 18 patients, partial-thickness defects in 7 patients, and full-thickness defects in 1 patient.

CONCLUSION

Single- and double-row techniques provide comparable clinical outcome at 2 years. A double-row technique produces a mechanically superior construct compared with the single-row method in restoring the anatomical footprint of the rotator cuff, but these mechanical advantages do not translate into superior clinical performance.

摘要

背景

恢复解剖足迹可能会改善修复肌腱的愈合情况和机械强度。双排缝合锚钉可增加肌腱与骨的接触面积,重建肩袖足迹更符合解剖结构的形态。

假设

肩袖撕裂的单排和双排缝合锚钉技术修复在临床和影像学结果上没有差异。

研究设计

随机对照试验;证据等级,1级。

方法

作者招募了60例患者。30例患者采用单排缝合锚钉技术进行肩袖修复(第1组)。另外30例患者采用双排缝合锚钉技术进行肩袖修复(第2组)。

结果

8例患者(单排锚钉修复组4例,双排锚钉修复组4例)在最终随访时未返回。在2年随访时,加利福尼亚大学洛杉矶分校评分和活动度值方面未见统计学显著差异。在2年随访时,第1组术后磁共振关节造影显示14例患者肌腱完整,10例患者有部分厚度缺损,2例患者有全层厚度缺损。在第2组中,磁共振关节造影显示18例患者肩袖完整,7例患者有部分厚度缺损,1例患者有全层厚度缺损。

结论

单排和双排技术在2年时提供了相当的临床结果。与单排方法相比,双排技术在恢复肩袖解剖足迹方面产生了机械性能更优的结构,但这些机械优势并未转化为更优的临床性能。

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