Department of Orthopaedic Surgery, Chungnam National University Hospital, 640 Daesa-Dong, Jung-Gu, Daejeon 301-721, South Korea.
Am J Sports Med. 2013 Feb;41(2):271-7. doi: 10.1177/0363546512468278. Epub 2012 Dec 11.
No reported study has compared the clinical outcomes of suture bridge techniques.
To compare the functional outcomes and repair integrity of the arthroscopic single-mattress (SM), double-pulley (DP), and double-mattress (DM) suture bridge (SB) techniques for full-thickness rotator cuff tears.
Cohort study; Level of evidence, 2.
Seventy-eight consecutive shoulders with full-thickness rotator cuff tears and a 1- to 4-cm anteroposterior dimension underwent arthroscopic SB repairs. The SM-SB technique was used in the first 26 consecutive shoulders, the DP-SB method was used in the second 26 consecutive shoulders, and the DM-SB repair was used in the final 26 consecutive shoulders. Seventy-four shoulders (94.9%) underwent postoperative evaluation for cuff integrity using MRI or ultrasound. Clinical outcomes were evaluated in 76 shoulders (97.4%) at a minimum of 2 years postoperatively. Clinical outcomes were evaluated using the shoulder rating scale of the University of California, Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and Constant scores at an average of 31 months postoperatively.
At final follow-up, the average ASES, UCLA, and Constant scores improved significantly: respective scores were 88.46, 30.58, and 73.96 in the SM-SB group (P < .001); 87.19, 31.35, and 72.50 in the DP-SB group (P < .001); and 87.19, 32.81, and 75.35 in the DM-SB group (P < .001). However, there were no significant differences among the 3 groups in terms of the ASES, UCLA, or Constant scores (P = .954, .210, and .755, respectively). The retear rate of repaired rotator cuffs was 20% in the SM-SB group, 12.5% in the DP-SB group, and 12% in the DM-SB group; however, the differences among the 3 groups were not statistically significant (P = .674). The number of suture anchors (mean ± SD) used for repair was 4.31 ± 0.47 in the SM-SB group, 4.00 ± 0.00 in the DP-SB group, and 3.38 ± 0.50 in the DM-SB group (P < .001).
Arthroscopic rotator cuff repair yielded successful functional outcomes without significant differences among the 3 SB techniques. Additionally, no significant differences in repair integrity were observed among the 3 methods postoperatively.
尚无研究比较缝合桥技术的临床结果。
比较关节镜下单针（SM）、双滑（DP）和双针（DM）缝合桥（SB）技术治疗全层肩袖撕裂的功能结果和修复完整性。
队列研究；证据水平，2 级。
78 例连续全层肩袖撕裂伴前后径 1-4cm 的患者接受关节镜 SB 修复。第 1-26 例连续肩采用 SM-SB 技术，第 2-26 例连续肩采用 DP-SB 方法，最后 26 例连续肩采用 DM-SB 修复。74 例（94.9%）术后通过 MRI 或超声评估肩袖完整性。76 例（97.4%）患者在术后至少 2 年进行临床结果评估。术后平均 31 个月时，使用加利福尼亚大学洛杉矶分校（UCLA）、美国肩肘外科医师协会（ASES）和 Constant 评分评估临床结果。
末次随访时，ASES、UCLA 和 Constant 评分均显著改善：SM-SB 组分别为 88.46、30.58 和 73.96（P<0.001）；DP-SB 组分别为 87.19、31.35 和 72.50（P<0.001）；DM-SB 组分别为 87.19、32.81 和 75.35（P<0.001）。然而，3 组在 ASES、UCLA 或 Constant 评分方面无显著差异（P=0.954、0.210 和 0.755）。SM-SB 组肩袖修复后再撕裂率为 20%，DP-SB 组为 12.5%，DM-SB 组为 12%；但 3 组间差异无统计学意义（P=0.674）。用于修复的缝线锚钉数量（均值±标准差）在 SM-SB 组为 4.31±0.47，DP-SB 组为 4.00±0.00，DM-SB 组为 3.38±0.50（P<0.001）。
关节镜肩袖修复可获得满意的功能结果，3 种 SB 技术之间无显著差异。此外，术后 3 种方法在修复完整性方面无显著差异。
