Caplan Jill L, Whitfield Bryan, Neviaser Robert J
The Department of Orthopedic Surgery, The George Washington University, Washington, DC 20037, USA.
J Shoulder Elbow Surg. 2009 Mar-Apr;18(2):193-6; discussion 197-8. doi: 10.1016/j.jse.2008.10.019. Epub 2008 Dec 31.
We studied the results of tendon-to-tendon repair of the subscapularis during total shoulder arthroplasty (TSA) to compare its clinical results relative to more recent studies looking at osteotomy of the lesser tuberosity.
This study analyzed the postoperative integrity of the subscapularis by a tendon-to-tendon repair in 45 arthroplasties in 43 patients.
Preoperatively, 23 patients had a negative lift-off test; 22 could not perform the test. Postoperatively, 41 patients had a negative lift-off test; four could not reach behind themselves to do the test. All 45 shoulders had a negative belly-press test pre-operatively and post-operatively.
Tendon-to-tendon repair is simpler, quicker, and avoids the possibility of an osteotomy nonunion. Tendon-to-tendon repair of the subscapularis tenotomy in shoulder arthroplasty remains an option in the presence of reasonable quality tendon, utilizing relaxing sutures (partial closure of the lateral rotator interval), and limiting early postoperative passive external rotation.
Level 4; Retrospective case series, no control group.
我们研究了全肩关节置换术（TSA）期间肩胛下肌肌腱对肌腱修复的结果，以将其临床结果与最近关于小粗隆截骨术的研究进行比较。
本研究分析了43例患者45例关节成形术中通过肌腱对肌腱修复的肩胛下肌术后完整性。
术前，23例患者抬起试验阴性；22例无法进行该试验。术后，41例患者抬起试验阴性；4例无法够到身后进行该试验。所有45例肩部术前和术后腹部按压试验均为阴性。
肌腱对肌腱修复更简单、更快，且避免了截骨不愈合的可能性。在肌腱质量合理的情况下，在肩关节置换术中对肩胛下肌腱切断进行肌腱对肌腱修复仍是一种选择，可采用松弛缝合（部分闭合外侧旋转肌间隙），并限制术后早期被动外旋。
4级；回顾性病例系列，无对照组。
