Department of Orthopaedics and Traumatology, University of Rome Sapienza, Rome, Italy.
Curr Med Res Opin. 2012 Nov;28(11):1767-74. doi: 10.1185/03007995.2012.737772. Epub 2012 Oct 19.
Arthroscopic rotator cuff repair generally provides satisfactory result, in terms of decreasing shoulder pain, resulting in improvement in range of motion. Unfortunately, imaging studies have shown that after surgical repair re-rupture rate is potentially high. Literature data indicate that each of the components present in a commercial supplement sold in Italy as Tenosan * (arginine L-alpha-ketoglutarate, methylsulfonylmethane, hydrolyzed type I collagen and bromelain) have a potential role in tendon healing and mitigating the pain due to tendonitis. We evaluated the clinical and MRI results of rotator cuff repair with and without the employment of this oral supplement in patients with a large, postero-superior rotator cuff tear (RCT).
We enrolled 90 consecutive patients who had a large, postero-superior RCT. All the lesions were managed with an arthroscopic repair. Patients were randomized and treated either with (Group I) or without (Group II) the supplement. The primary outcomes were the difference between the pre- and post-operative Constant score and repair integrity assessed by MRI according to Sugaya's classification. The secondary outcome was the pre- and post-operative Simple Shoulder Test.
No statistically significant differences were identified between the two groups for each considered variable, except for shoulder pain (follow-up: 6 months) and repair integrity (final follow-up). Intensity of shoulder pain was lower in the Group I patients (p < 0.001). Analogously, in Group I, the percentage of patients with a better repair integrity result was significantly higher than Group II.
The use of the supplement for 3 months after cuff repair decreases shoulder post-operative pain and leads to a slight improvement in repair integrity. This improvement does not seem to correlate with an better objective functional outcome. However, these effects could facilitate and abbreviate the post-operative rehabilitation program and reduce re-rupture rate. The main limitations of this study are the relative short follow-up period and small number of patients studied.
关节镜下肩袖修复术可显著减轻肩部疼痛，改善活动范围，从而获得满意的疗效。然而，影像学研究表明，术后再撕裂的发生率仍然较高。文献资料表明，意大利市售 Tenosan *（精氨酸 L-α-酮戊二酸、甲磺酰甲烷、水解 I 型胶原和菠萝蛋白酶）中的每一种成分都可能在肌腱愈合和缓解肌腱炎疼痛方面发挥作用。我们评估了在大型肩袖后上侧撕裂（RCT）患者中，使用和不使用该口服补充剂进行肩袖修复的临床和 MRI 结果。
我们纳入了 90 例连续的大型肩袖后上侧 RCT 患者。所有病变均采用关节镜下修复。患者随机分为两组，一组（I 组）使用该补充剂，另一组（II 组）不使用。主要结局是术前和术后 Constant 评分的差异以及根据 Sugaya 分类评估的修复完整性。次要结局是术前和术后的简易肩功能测试。
两组间除肩痛（随访：6 个月）和修复完整性（最终随访）外，每个考虑因素的变量均无统计学差异。I 组患者的肩痛强度较低（p<0.001）。类似地，I 组中修复完整性更好的患者比例明显高于 II 组。
在肩袖修复后 3 个月使用该补充剂可减轻术后肩部疼痛，并略微改善修复完整性。这种改善似乎与更好的客观功能结果无关。然而，这些效果可能会促进和缩短术后康复计划，并降低再撕裂的风险。本研究的主要局限性是随访时间相对较短且患者数量较少。
