Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, South Korea..
Am J Sports Med. 2012 Feb;40(2):294-9. doi: 10.1177/0363546511425657. Epub 2011 Nov 10.
Only a few studies have examined repair integrity and functional outcome after arthroscopic suture-bridge rotator cuff repair procedure. In addition, no reported study has compared outcomes between the suture-bridge and double-row techniques.
This study compared the functional outcome and repair integrity of arthroscopic double-row and conventional suture-bridge repair in full-thickness rotator cuff tears.
Cohort study; Level of evidence, 2.
Fifty-two consecutive full-thickness rotator cuff tears with 1 to 4 cm of anterior to posterior dimension that underwent arthroscopic rotator cuff repair were included. A double-row technique was used in the first 26 consecutive shoulders, and a conventional suture-bridge technique was used in the next 26 consecutive shoulders. Fifty shoulders (92.5%) underwent magnetic resonance imaging or ultrasonography postoperatively. Clinical outcomes were evaluated a minimum 2 years (mean, 37.2 months; range, 24-54) postoperatively using the University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and Constant scores. The postoperative cuff integrity was evaluated a mean of 33.0 (range, 10-54) months postoperatively.
At the final follow-up, the average UCLA, ASES, and Constant scores improved significantly, to 32.3, 90.5, and 80.7, respectively, in the double-row group and to 30.6, 88.5, and 74.0, respectively, in the suture-bridge group. The UCLA, ASES, and Constant scores improved in both groups postoperatively (all P < .001); however, there was no significant difference between the 2 groups at final follow-up (P = .185, .585, and .053, respectively). The retear rate was 24% in the shoulders that underwent double-row repair and 20% in the shoulders that underwent suture-bridge repair; this difference was not statistically significant (P = .733).
The arthroscopic conventional suture-bridge technique resulted in comparable patient satisfaction, functional outcome, and rates of retear compared with the arthroscopic double-row technique in full-thickness rotator cuff tears.
仅有少数研究调查了关节镜下缝合桥修复术治疗肩袖全层撕裂后的修复完整性和功能结果。此外,尚无研究报告比较缝合桥与双排技术的结果。
本研究比较了关节镜下双排和传统缝合桥修复全层肩袖撕裂的功能结果和修复完整性。
队列研究;证据等级,2 级。
纳入 52 例连续全层肩袖撕裂患者,撕裂的前后径为 1 至 4 cm,均接受关节镜肩袖修复。前 26 例连续患者采用双排技术,后 26 例连续患者采用传统缝合桥技术。50 例(92.5%)术后行磁共振成像或超声检查。术后至少 2 年(平均 37.2 个月;范围,24-54 个月)采用加利福尼亚大学洛杉矶分校(UCLA)评分、美国肩肘外科医师协会(ASES)评分和Constant 评分进行临床评估。术后平均 33.0 个月(范围,10-54 个月)评估术后肩袖完整性。
末次随访时,双排组的 UCLA、ASES 和 Constant 评分分别显著改善至 32.3、90.5 和 80.7,缝合桥组分别改善至 30.6、88.5 和 74.0。两组术后 UCLA、ASES 和 Constant 评分均改善(均 P <.001);但末次随访时两组间差异无统计学意义(P =.185、.585 和.053)。双排修复组的再撕裂率为 24%,缝合桥修复组为 20%,差异无统计学意义(P =.733)。
在全层肩袖撕裂中,关节镜下传统缝合桥技术与关节镜下双排技术相比,患者满意度、功能结果和再撕裂率相当。