Klinik für Orthopädie und Unfallchirurgie, Klinikum rechts der Isar, Technischen Universität München, Ismaningerstrasse 22, Munich, Germany.
Arch Orthop Trauma Surg. 2012 Mar;132(3):305-10. doi: 10.1007/s00402-011-1369-3. Epub 2011 Aug 17.
The current study was designed to evaluate the rate of osteolysis and the clinical and functional outcomes in patients who underwent mini-open rotator cuff repairs using first generation bioabsorbable suture anchors. Our hypothesis was that patients with osteolysis noted on post-repair MRI would have an accompanying decrease in functional and clinical patient outcomes when compared with patients who did not have osteolysis evident on post-repair MRI.
Clinical retrospective study.
Between September 2000 and May 2004, 76 patients were repaired using first generation Bio-Corkscrew suture anchors (Arthrex, Naples, FL). 30 patients were available for complete follow-up evaluation. The mean follow-up time was 36 months (range 24-58). Patients were assessed with the Constant-Murley Score, radiographs and magnetic resonance imaging (MRI). Post-operative strength was measured using an Isokinetic Cybex-Dynamometer. 14 patients had osteolysis evident on MRI (Group A) while 16 patients did not have osteolysis on MRI (Group B).
In both groups, a total of 70 bio-anchors were used. 22 anchors showed osteolytic changes on MRI (Group A). Concerning ROM, there was no statistical difference in both groups. The Constant-Score was statistically not different in both groups A (92.4) and B (83.7). On MRI-scans, there were repair failures in both groups (A, 2 reruptures; B, 3 reruptures).
Although, we found a high rate of osteolysis after rotator cuff repair with bioabsorbable anchors, these results did not change the clinical outcomes after rotator cuff repair. Recurrent tears were not significantly different in both groups and are comparable to rerupture rates in prior studies. More studies are needed to verify the effect of osteolysis over the long term.
本研究旨在评估使用第一代生物可吸收缝合锚进行微创肩袖修复后骨溶解的发生率以及患者的临床和功能结果。我们的假设是,与修复后 MRI 未见骨溶解的患者相比,修复后 MRI 显示有骨溶解的患者在功能和临床患者结果方面会出现下降。
临床回顾性研究。
在 2000 年 9 月至 2004 年 5 月期间,使用第一代 Bio-Corkscrew 缝合锚(Arthrex,Naples,FL)修复了 76 例患者。有 30 例患者可进行完整的随访评估。平均随访时间为 36 个月(范围 24-58 个月)。使用 Constant-Murley 评分、X 线片和磁共振成像(MRI)对患者进行评估。术后力量使用等速 Cybex-Dynamometer 进行测量。14 例患者的 MRI 显示有骨溶解(A 组),16 例患者的 MRI 无骨溶解(B 组)。
在两组中,共使用了 70 个生物锚。22 个锚在 MRI 上显示出溶骨性改变(A 组)。在 ROM 方面,两组之间没有统计学差异。两组的 Constant 评分均无统计学差异(A 组为 92.4,B 组为 83.7)。在 MRI 扫描中,两组均有修复失败(A 组 2 例再撕裂;B 组 3 例再撕裂)。
尽管我们发现使用生物可吸收锚进行肩袖修复后骨溶解的发生率较高,但这些结果并未改变肩袖修复后的临床结果。两组的复发性撕裂均无显著差异,与先前研究中的再撕裂率相当。需要更多的研究来验证骨溶解在长期内的影响。