Bond James L, Dopirak Ryan M, Higgins Jason, Burns Joseph, Snyder Stephen J
Department of Orthopaedics, The University of Oklahoma, Oklahoma City, Oklahoma 73190, USA.
Arthroscopy. 2008 Apr;24(4):403-409.e1. doi: 10.1016/j.arthro.2007.07.033.
Our purpose was to assess the short-term results and describe the technique of arthroscopic repair of irreparable rotator cuff tears by use of a GraftJacket allograft (Wright Medical Technology, Arlington, TN).
Between March 2003 and February 2004, 16 patients with massive, contracted, immobile rotator cuff tears were treated with arthroscopic placement of a GraftJacket allograft by a single surgeon. Patients were followed up for 1 to 2 years. All were evaluated preoperatively and postoperatively by use of the modified University of California, Los Angeles scoring system, Constant score, and Simple Shoulder Test. Magnetic resonance imaging was performed postoperatively at 3 months and 1 year.
At a mean follow-up of 26.8 months (range, 12 to 38 months), 15 of 16 patients were satisfied with the procedure. The mean University of California, Los Angeles score increased from 18.4 preoperatively to 30.4 postoperatively (P = .0001). The Constant score increased from 53.8 to 84.0 (P = .0001). Statistically significant improvements were seen in pain, forward flexion, and external rotation strength. Thirteen patients had full incorporation of the graft into the native tissue as documented on magnetic resonance imaging. There were no complications in this cohort of patients.
Our study supports GraftJacket allograft as a viable solution for surgical salvage in select cases of massive, irreparable rotator cuff pathology. This treatment option may provide patients with decreased pain and increased function despite a previously irreparable rotator cuff tear.
Level IV, therapeutic case series.
我们的目的是评估使用GraftJacket同种异体移植物（Wright Medical Technology，阿灵顿，田纳西州）进行关节镜下修复不可修复的肩袖撕裂的短期结果，并描述该技术。
在2003年3月至2004年2月期间，16例患有巨大、挛缩、固定不动的肩袖撕裂患者由一名外科医生通过关节镜置入GraftJacket同种异体移植物进行治疗。对患者进行了1至2年的随访。所有患者术前和术后均使用改良的加州大学洛杉矶分校评分系统、Constant评分和简单肩部测试进行评估。术后3个月和1年进行磁共振成像检查。
平均随访26.8个月（范围12至38个月），16例患者中有15例对手术满意。加州大学洛杉矶分校平均评分从术前的18.4分提高到术后的30.4分（P = .0001）。Constant评分从53.8分提高到84.0分（P = .0001）。在疼痛、前屈和外旋力量方面有统计学意义的改善。13例患者的移植物在磁共振成像上显示已完全融入原生组织。该组患者无并发症发生。
我们的研究支持GraftJacket同种异体移植物作为在某些巨大、不可修复的肩袖病变病例中进行手术挽救的可行解决方案。尽管之前肩袖撕裂不可修复，但这种治疗选择可能会减轻患者疼痛并改善功能。
IV级，治疗性病例系列。
