Kang Lana, Henn R Frank, Tashjian Robert Z, Green Andrew
Department of Orthopaedics, Brown University Medical School, Providence, Rhode Island, USA.
Arthroscopy. 2007 Jun;23(6):573-82, 582.e1-2. doi: 10.1016/j.arthro.2007.01.011.
The purpose of this study was to compare the early functional outcome of mini-open and arthroscopic rotator cuff repair.
This was a retrospective study of 128 patients with chronic small- and medium-sized rotator cuff tears who underwent mini-open rotator cuff repair (MRCR) (n=63) or arthroscopic rotator cuff repair (ARCR) (n = 65). Data were collected prospectively at baseline 1 to 2 weeks before surgery and at 3 and 6 months after surgery. Patients were identified from a prospectively created database based on the dimensions of the size of the tear as determined intraoperatively. Outcome was assessed via physical examination, visual analog scales (VASs), the Simple Shoulder Test, the Disabilities of the Arm, Shoulder and Hand questionnaire, and the Short Form 36 (SF-36) Health Survey. Changes between baseline and follow-up were compared.
All demographic variables and preoperative baseline parameters of the 2 groups were equivalent. At 3 and 6 months, both MRCR and ARCR showed statistically significant improvement in all patient-derived outcome parameters (P < or = .0001) except for three SF-36 variables. The improvements in the SF-36 bodily pain score at 3 months postoperatively (P = .041) and the VAS pain score at 6 months postoperatively (P = .03) were better for ARCR. All other improvements in patient-derived parameters were equivalent.
In our retrospective study we found that the early functional outcomes of MRCR and ARCR of small- and medium-sized rotator cuff tears are nearly equivalent. In light of the purported advantages of ARCR that motivate its popularity, this is an unexpected finding. However, an equally important result of this study was the finding that ARCR was associated with statistically significant improvement in the 3-month SF-36 bodily pain score and 6-month VAS pain score (P = .041 and .03, respectively).
Level III, retrospective therapeutic comparative study.
本研究旨在比较小切口开放与关节镜下肩袖修补术的早期功能结局。
这是一项回顾性研究，纳入128例慢性中小型肩袖撕裂患者，其中63例行小切口开放肩袖修补术（MRCR），65例行关节镜下肩袖修补术（ARCR）。术前1至2周及术后3个月和6个月前瞻性收集数据。根据术中确定的撕裂大小维度，从一个前瞻性创建的数据库中识别患者。通过体格检查、视觉模拟量表（VAS）、简易肩关节测试、手臂、肩部和手部功能障碍问卷以及简明健康调查36项量表（SF-36）评估结局。比较基线与随访之间的变化。
两组的所有人口统计学变量和术前基线参数均相当。在3个月和6个月时，除了三个SF-36变量外，MRCR和ARCR在所有患者源性结局参数方面均显示出统计学上的显著改善（P≤0.0001）。ARCR术后3个月的SF-36身体疼痛评分改善情况（P = 0.041）以及术后6个月的VAS疼痛评分改善情况（P = 0.03）更好。患者源性参数的所有其他改善情况相当。
在我们的回顾性研究中，我们发现中小型肩袖撕裂的MRCR和ARCR的早期功能结局几乎相当。鉴于ARCR所谓的优势使其受到欢迎，这是一个出乎意料的发现。然而，本研究同样重要的结果是发现ARCR与3个月时的SF-36身体疼痛评分和6个月时的VAS疼痛评分在统计学上的显著改善相关（分别为P = 0.041和0.03）。
III级，回顾性治疗比较研究。
