Department of Orthopaedic Surgery and Traumatology, Henri Mondor Hospital, Paris Public Assistance Hospitals Group, Créteil School of Medicine (Paris XII University), 94010 Créteil cedex, France.
Orthop Traumatol Surg Res. 2010 Nov;96(7):727-33. doi: 10.1016/j.otsr.2010.05.003.
Although simple suturing repair of a full thickness cuff tear can be performed when the preoperative fatty degeneration index (FDI) is 2 or less, it is not known if the functional results will be better than palliative surgical treatment. The aim of this study is to describe and validate a method to predict the intermediate term unweighted Constant scores of different surgical treatments based on preoperative FDI. The hypothesis of this study is that the preoperative and final follow-up ratios FDI/final follow-up Constant scores regression lines, established on a previous "reference study"[5] (a series of 29 shoulders with cuff tears and sutured intact rotator cuff), could be used for this purpose.
The present study included seven series of sutured cuffs (five, which resulted in intact cuffs and two in recurrent tears) and one series of cuffs treated with palliative surgery. Knowledge of the preoperative FDI and the location of the recurrent or unrepaired tears were required criteria for these series inclusion in the study.
For each of the series in this study the Constant scores and selected score items were compared to scores calculated with the same mathematical formulas previously used to determine the regression lines in the reference study series (resulting in Constant scores in relation to preoperative and final follow-up FDI).
The calculated Constant scores were similar to those reported by the authors, which validate the proposed method.
Because of the small size of the series of sutured cuffs with recurrent tears and of cuffs that underwent palliative surgery and arthroscopic treatment it is impossible to definitely confirm the validity of this method.
The intermediate term results of different surgical treatments can reasonably be predicted for full thickness tendon tears based on the preoperative FDI and the location of these tears. With this method the best treatment should be chosen for a rotator cuff tear on a case-by-case basis.
Level IV.
虽然术前脂肪变性指数（FDI）为 2 或更低时可以进行全层肩袖撕裂的简单缝合修复，但尚不清楚功能结果是否会优于姑息性手术治疗。本研究的目的是描述和验证一种基于术前 FDI 预测不同手术治疗中期无权重 Constant 评分的方法。本研究的假设是，在先前的“参考研究”[5]（一系列 29 例肩袖撕裂和缝合完整的肩袖）中建立的术前和最终随访 FDI/最终随访 Constant 评分回归线，可以用于此目的。
本研究包括七个缝合肩袖系列（五个导致肩袖完整，两个导致肩袖再次撕裂）和一个姑息性手术治疗肩袖系列。这些系列纳入研究的标准是需要了解术前 FDI 和复发性或未修复撕裂的位置。
对于本研究中的每个系列，使用先前用于确定参考研究系列回归线的相同数学公式比较 Constant 评分和选定的评分项目（导致与术前和最终随访 FDI 相关的 Constant 评分）。
计算出的 Constant 评分与作者报告的评分相似，验证了所提出的方法。
由于复发性肩袖撕裂的缝合肩袖系列和接受姑息性手术和关节镜治疗的肩袖系列较小，因此无法确定该方法的有效性。
基于术前 FDI 和这些撕裂的位置，可以合理地预测全层肌腱撕裂的不同手术治疗的中期结果。通过这种方法，可以根据具体情况为肩袖撕裂选择最佳治疗方法。
IV 级。
