The Orthopedic Institute of Wisconsin, Midwest Orthopedic Specialty Hospital, 3111 W Rawson Ave., Franklin, WI 53132, U.S.A.
Arthroscopy. 2010 Nov;26(11):1419-26. doi: 10.1016/j.arthro.2010.03.013. Epub 2010 Sep 26.
Our goal in this analysis was to compare clinical outcomes and radiographic healing rates of double-row (DR) transosseous-equivalent versus single-row (SR) Mason-Allen configuration (MAC) arthroscopic repair techniques.
A prospective, nonrandomized assessment of 132 arthroscopic rotator cuff repair patients included 78 SR repair patients and 54 with DR repair. Tears measured between 1.5 and 4.5 cm. Patients were evaluated with a visual analog scale; University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; active range of motion; and dynamometric strength. Scores and measurements were obtained preoperatively and at 3, 6, 12, and 24 months postoperatively. The SR repairs were performed with the arthroscopic MAC. For DR repairs, two 5.5-mm fully threaded Bio-Corkscrew anchors (Arthrex, Naples, FL), single loaded with FiberWire (Arthrex), were used for the medial row. The lateral row was secured with PushLock bioabsorbable anchors (Arthrex). Forty-four patients in the SR group and 37 patients in the DR group returned for magnetic resonance imaging (MRI) evaluation of repair integrity between 12 and 28 months postoperatively.
DR repairs resulted in higher outcome scores, though not significantly. Patient satisfaction rates were 95% in the SR group and 92% in the DR group. MRI showed a statistically significantly improved healing rate with SR repair compared with DR repair in our entire patient population (P ≤ .017). A more homogeneous subset of patients with tears between 2.5 and 3.5 cm showed a significantly improved healing rate for the DR repair (P ≤ .03).
Our short-term results suggest that SR MAC repair provides comparable clinical results to DR repair. Although our MRI data suggest improved healing rates in our SR repairs in the entire patient population, when similar-sized tears were compared, the DR repair group showed improved radiographic healing.
Level III, retrospective comparative study.
本分析旨在比较双排（DR）经骨隧道等同于单排（SR）Mason-Allen 构型（MAC）关节镜修复技术的临床结果和放射学愈合率。
对 132 例关节镜肩袖修复患者进行前瞻性、非随机评估，其中 78 例接受 SR 修复，54 例接受 DR 修复。撕裂长度在 1.5 至 4.5cm 之间。患者接受视觉模拟评分、加州大学洛杉矶分校评分、美国肩肘外科医师评分、主动活动范围和测力强度评估。术前及术后 3、6、12 和 24 个月时获取评分和测量值。SR 修复采用关节镜 MAC 进行。对于 DR 修复，使用两个 5.5mm 全螺纹 Bio-Corkscrew 锚钉（Arthrex，那不勒斯，FL），单个加载 FiberWire（Arthrex），用于内侧排。外侧排用 PushLock 可吸收锚钉（Arthrex）固定。SR 组 44 例和 DR 组 37 例患者在术后 12 至 28 个月行 MRI 评估修复完整性。
DR 修复的结果评分较高，但无统计学意义。SR 组患者满意度为 95%，DR 组为 92%。MRI 显示，在我们的所有患者人群中，SR 修复的愈合率明显高于 DR 修复（P≤0.017）。对于 2.5 至 3.5cm 之间撕裂的更同质患者亚组，DR 修复的愈合率明显提高（P≤0.03）。
我们的短期结果表明，SR MAC 修复与 DR 修复提供相当的临床结果。尽管我们的 MRI 数据表明，我们的 SR 修复在整个患者人群中的愈合率提高，但当比较相似大小的撕裂时，DR 修复组显示出更好的放射学愈合。
III 级，回顾性比较研究。
