Kerlan-Jobe Orthopaedic Clinic, Los Angeles, CA, USA.
J Shoulder Elbow Surg. 2012 May;21(5):589-96. doi: 10.1016/j.jse.2011.04.008. Epub 2011 Jul 22.
It is unknown which type of rotator cuff repair technique best isolates the healing zone interface from the synovial fluid environment. The purpose of this study was to determine the leakage area and pattern onto the rotator cuff footprint after 3 different rotator cuff repairs.
Six fresh frozen cadaveric glenohumeral joints in each of 3 groups were injected with gelatin to a pressure of 103 mm Hg (∼2 psi) after 1 of 3 different rotator cuff repairs of a supraspinatus tear: (1) single-row repair (SR), (2) knotless transosseous equivalent repair (KTE), and (3) traditional transosseous equivalent repair (TTE), which uses medial tied knots. Specimens were cycled in external rotation and abduction and were cooled to allow the gelatin to solidify. The supraspinatus was dissected off the footprint and photographs were taken. Scion Image (Frederick, MD, USA) was used to quantify the area.
The average area of leakage was 1.09 cm(2) for the SR and 1.15 cm(2) for the KTE. The TTE did not demonstrate any leakage. The pattern of leakage for the KTE was medial and central on the footprint, whereas the SR demonstrated leakage up to the tied knots. The difference in the area of leakage in the SR and KTE compared with the TTE was statistically significant. There was no difference in area of leakage between the SR and KTE.
A transosseous equivalent repair technique best prevents leakage onto the rotator cuff footprint compared with single-row and knotless repairs.
目前尚不清楚哪种类型的肩袖修复技术能将愈合区界面与滑液环境最佳隔离。本研究旨在确定 3 种不同肩袖修复方法后，漏液区域及模式在肩袖止点上的分布。
每组 6 个新鲜冷冻的肩盂肱关节，在 3 组肩袖撕裂的 1 种修复方式后注入明胶，压力为 103mmHg（约 2psi）：（1）单排修复（SR）；（2）无结腱骨道等同修复（KTE）；（3）传统腱骨道等同修复（TTE），后者使用内侧打结。标本在外展和外旋下循环，并冷却以允许明胶凝固。从止点上解剖冈上肌，并拍照。使用 ScionImage（美国马里兰州弗雷德里克）定量分析面积。
SR 的平均漏液面积为 1.09cm²，KTE 为 1.15cm²。TTE 未显示任何漏液。KTE 的漏液模式为止点的内侧和中央，而 SR 显示直至打结处的漏液。SR 和 KTE 与 TTE 相比，漏液面积的差异具有统计学意义。SR 和 KTE 的漏液面积无差异。
与单排和无结修复相比，腱骨道等同修复技术能最佳防止漏液至肩袖止点上。
