Melbourne Shoulder and Elbow Centre, 31 Normanby Street, Brighton, Victoria 3186, Australia.
J Bone Joint Surg Am. 2013 Jan 16;95(2):151-7. doi: 10.2106/JBJS.K.00499.
Rotator cuff tears are a common clinical problem, and few long-term studies concerning the outcomes of rotator cuff repairs have been performed. The purpose of this study was to report the fifteen-year outcomes of arthroscopic subacromial decompression with mini-open rotator cuff repair.
The study included seventy-nine patients who had undergone arthroscopic subacromial decompression with mini-open rotator cuff repair from 1993 to 1996. Outcomes were reviewed in 1997, 2002, and 2010. At the final review, forty-nine patients (forty-nine shoulders) were available or were suitable for evaluation. There were eight large tears, forty medium tears, and one small tear. The patients were assessed with the University of California, Los Angeles (UCLA) score at each evaluation. The mean age of the patients at the time of follow-up was 70.1 years, and the mean follow-up period was 15.6 years.
At the time of final follow-up, the outcome was good or excellent in thirty-four patients (69%), fair in seven, and poor in eight. Three patients required a reoperation. Between the two and fifteen-year evaluations, twenty-nine patients (59%) had maintained their good or excellent result; the overall raw scores had deteriorated for fifteen patients (31%), and they had improved for twenty-four (49%). Forty-one patients (84%) were satisfied with the final outcome of the shoulder surgery.
This study shows that arthroscopic subacromial decompression with mini-open rotator cuff repair can provide a lasting, durable, and satisfactory outcome for a large proportion of patients fifteen years after surgery. Patient satisfaction at the final evaluation did not necessarily correspond with a good or an excellent UCLA score.
肩袖撕裂是一种常见的临床问题,针对肩袖修复术后结果的长期研究较少。本研究旨在报告关节镜下肩峰下减压术联合小切口肩袖修复术的 15 年结果。
本研究纳入了 1993 年至 1996 年接受关节镜下肩峰下减压术联合小切口肩袖修复术的 79 例患者。分别于 1997 年、2002 年和 2010 年进行了随访。最终随访时,49 例(49 侧)患者可获得或适合评估。其中 8 例为巨大撕裂,40 例为中等撕裂,1 例为小撕裂。每位患者在每次评估时均采用加州大学洛杉矶分校(UCLA)评分进行评估。随访时患者的平均年龄为 70.1 岁,平均随访时间为 15.6 年。
最终随访时,34 例(69%)患者的结果为优或良,7 例为可,8 例为差。3 例患者需要再次手术。在 2 年至 15 年的随访期间,29 例(59%)患者保持了优或良的结果;15 例(31%)患者的原始评分恶化,24 例(49%)患者的评分改善。41 例(84%)患者对肩部手术的最终结果满意。
本研究表明,关节镜下肩峰下减压术联合小切口肩袖修复术可使大部分患者在术后 15 年获得持久、耐用且满意的结果。最终评估时患者的满意度并不一定与良好或优秀的 UCLA 评分相对应。