Goutallier Daniel, Postel Jean-Marie, Radier Catherine, Bernageau Jacques, Zilber Sebastien
Department of Orthopedic Surgery, Henri Mondor Teaching Hospital, Créteil School of Medicine (Paris XII University), Assistance Publique-Hopitaux de Paris, Créteil, France.
J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):521-8. doi: 10.1016/j.jse.2008.11.006. Epub 2009 Feb 11.
Tendon-to-bone suture and a fatty degeneration index (FDI) <or= 2 are required to achieve an intact cuff in the mid-term. Our primary objective was to determine the structural and functional long-term outcomes of repaired cuffs that were intact after one year.
We studied 30 cuffs with FDI <or= 2 at surgery and no tear one year after tension-free tendon-to-bone suture. Mean follow-up was 9 +/- 0.8 years. Gross tendon-stump lesions were excised prior to repair.
Re-tear after one year was rare: only one cuff showed a recurrent tear. In the 29 intact cuffs, mean un-weighted Constant score and sub-scores improved significantly (P values, < .0001- .0002; final Constant score = 77) for two years then remained stable. FDI values increased during the first year and then remained stable. Mild osteoarthritis was noted in one shoulder at last follow-up.
Final functional outcomes correlated significantly to FDI at baseline and last follow-up. Tension free tendon-to-bone suture is effective functionally and structurally at nine years follow-up provided the FDI at surgery is <or= 2 and the repair is intact after one year.
Level 3; Retrospective cohort therapeutic study.
中期实现完整的肩袖需要腱骨缝合且脂肪变性指数（FDI）≤2。我们的主要目标是确定一年后仍完整的修复肩袖的结构和功能长期结果。
我们研究了30例手术时FDI≤2且在无张力腱骨缝合一年后无撕裂的肩袖。平均随访时间为9±0.8年。在修复前切除粗大的肌腱残端病变。
一年后再次撕裂很少见：只有一个肩袖出现复发性撕裂。在29个完整的肩袖中，平均未加权的Constant评分和子评分在两年内显著改善（P值＜0.0001-0.0002；最终Constant评分为77），然后保持稳定。FDI值在第一年增加，然后保持稳定。在最后一次随访时，一个肩部出现轻度骨关节炎。
最终功能结果与基线和最后随访时的FDI显著相关。如果手术时FDI≤2且一年后修复完整，无张力腱骨缝合在九年随访时在功能和结构上是有效的。
3级；回顾性队列治疗研究。
