Department of Orthopedic Surgery, Pain Research Center, Dongsan Medical Center, School of Medicine, Keimyung University, 194 Dongsan-dong, Joong-gu, Daegu, Korea.
Int Orthop. 2012 Jan;36(1):95-100. doi: 10.1007/s00264-011-1305-8. Epub 2011 Jun 30.
This study was undertaken to introduce an anterolateral approach for mini-open rotator cuff repair and evaluate its clinical outcome and effectiveness.
We evaluated 128 consecutive cases that were repaired by mini-open repair using an anterolateral approach. There were 80 men and 48 women, with an average age of 56.2 years. Average follow-up was 25.7 months. There were eight partial-thickness, 26 small, 40 medium, 39 large and 15 massive tears. After arthroscopic glenohumeral examination and subacromial decompression, we made a 3- to 4-cm skin incision from anterolateral edge of the acromion and dissected to the raphe between the anterior and middle deltoid. The torn tendon was repaired with single- or double-row technique using suture anchors. To prevent avulsion of the deltoid from the acromion, additional suturing within the bone tunnel was performed. We retrospectively evaluated clinical outcomes using the American Shoulder and Elbow Surgeon (ASES) scoring system.
The average visual analogue scale (VAS), activity of daily living (ADL) and ASES scores improved, respectively, from 6.6, 12.0 and 36.7 preoperatively to 1.2, 26.6 and 88.2 postoperatively. There were 71 excellent, 39 good, ten fair and eight poor results. There were no statistically significant difference between final ASES scores and age, symptom duration, tear size or preoperative stiffness, but men had significantly higher final ASES scores than women (P = 0.014).
Anterolateral approach for mini-open rotator cuff repair produces satisfactory results. It may also provide better visualisation for rotator cuff tears of all sizes.
本研究旨在介绍一种经前外侧入路的小切口肩袖修复方法，并评估其临床效果和疗效。
我们评估了 128 例连续采用经前外侧入路小切口修复的病例。其中男性 80 例，女性 48 例，平均年龄 56.2 岁。平均随访 25.7 个月。其中 8 例为部分厚度撕裂，26 例为小撕裂，40 例为中等撕裂，39 例为大撕裂，15 例为巨大撕裂。在关节镜下进行盂肱关节检查和肩峰下减压后，我们从前侧肩峰的前外侧缘做一个 3-4cm 的皮肤切口，向中间和前三角肌之间的腱膜切开。撕裂的肌腱用缝线锚钉进行单排或双排修复。为了防止三角肌从肩峰上撕脱，在骨隧道内进行额外的缝合。我们使用美国肩肘外科医生（ASES）评分系统对临床结果进行回顾性评估。
平均视觉模拟评分（VAS）、日常生活活动（ADL）和 ASES 评分分别从术前的 6.6、12.0 和 36.7 改善至术后的 1.2、26.6 和 88.2。其中 71 例为优秀，39 例为良好，10 例为可，8 例为差。最终 ASES 评分与年龄、症状持续时间、撕裂大小或术前僵硬程度之间无统计学差异，但男性的最终 ASES 评分明显高于女性（P = 0.014）。
经前外侧入路小切口肩袖修复可获得满意的效果。它也可能为各种大小的肩袖撕裂提供更好的可视化效果。
