Schär A, Schär M O, Zumstein M A
Sportorthopädie, Departement für Orthopädische Chirurgie und Traumatologie, Universität Bern, Inselspital, Bern, Schweiz.
Oper Orthop Traumatol. 2012 Nov;24(6):527-35. doi: 10.1007/s00064-012-0159-6.
Rotator cuff lesions are common and the incidence increases with age. After tendon rupture of the rotator cuff, the muscle-tendon unit retracts, which is accompanied by muscle fatty infiltration, atrophy, and interstitial fibrosis of the musculature, thus, fundamentally changing the muscle architecture. These changes are important prognostic factors for the operative rotator cuff reconstruction outcome. Selection of the correct time point for reconstruction as well as the optimal mechanical fixation technique are decisive for successful attachment at the tendon-to-bone insertion site. Thus, knowledge of the pathophysiological processes plays an important role. The goal of this article is to establish a relationship between currently existing evidence with respect to the preoperatively existing changes of the muscle-tendon unit and the choice of the time for the operation and the operative technique.
肩袖损伤很常见，且发病率随年龄增长而增加。肩袖肌腱断裂后，肌-腱单元会回缩，同时伴有肌肉脂肪浸润、萎缩以及肌肉组织的间质纤维化，从而从根本上改变肌肉结构。这些变化是肩袖手术重建效果的重要预后因素。选择正确的重建时间点以及最佳的机械固定技术对于在肌腱-骨插入部位成功附着起着决定性作用。因此，了解病理生理过程具有重要意义。本文的目的是建立目前关于术前肌-腱单元已有变化的现有证据与手术时间选择及手术技术之间的关系。
