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关节镜下双排肩袖缝合桥接修复术:两种技术的结构和功能比较

Arthroscopic double-row cuff repair with suture-bridging: a structural and functional comparison of two techniques.

作者信息

Boyer P, Bouthors C, Delcourt T, Stewart O, Hamida F, Mylle G, Massin P

机构信息

Orthopaedic Department, Bichat Hospital, Assistance Publique/Hôpitaux de Paris, University Paris VII, 46 rue Henri Huchard, 75018, Paris, France,

出版信息

Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):478-86. doi: 10.1007/s00167-013-2401-7. Epub 2013 Feb 13.

Abstract

PURPOSE

The aim of this study was to compare the functional and structural outcomes of 2 techniques for double-row, suture-bridging cuff repair.

METHODS

A consecutive series of 73 patients who underwent arthroscopic, double-row, suture-bridge primary rotator cuff repair of full-thickness supraspinatus tear were evaluated. Thirty-eight shoulders were repaired by the arthroscopic, tied, suture-bridging technique (group A), and 35 shoulders by knot-less bridging with suture tape material (group B). Constant scores, pain, range of motion, strength, and complications were measured after a minimum follow-up period of 12 months post-operatively. Structural integrity of the repairs was evaluated systematically by either magnetic resonance imaging or computed tomography arthrography.

RESULTS

Median follow-up after surgery was 29 (23-32) months in group A, and 21 (12-23) months in group B. Mean pain relief, range of motion, strength, and constant score improved significantly in both groups. No statistical differences were found between groups in the post-operative period. According to control imaging, the re-tear rate trended to be higher in group A (23.4 %) than in group B (17.1 %), although not significantly.

CONCLUSION

Both bridging repair techniques achieved successful functional outcomes. In terms of structural outcome, the knot-less tape-bridging construct showed a lower but not significant re-tear rate. Longer follow-up is needed to confirm these results and to evaluate potential differences between the two techniques.

LEVEL OF EVIDENCE

A prospective, non-randomized, comparative study, Level III.

摘要

目的

本研究旨在比较两种双排缝合桥接式肩袖修补技术的功能和结构结果。

方法

对连续73例行关节镜下全层冈上肌撕裂双排缝合桥接式初次肩袖修补术的患者进行评估。38例肩部采用关节镜下打结缝合桥接技术修复(A组),35例肩部采用无结缝合带材料桥接技术修复(B组)。术后至少随访12个月后测量Constant评分、疼痛、活动范围、力量和并发症情况。通过磁共振成像或计算机断层扫描关节造影系统评估修补的结构完整性。

结果

A组术后中位随访时间为29(23 - 32)个月,B组为21(12 - 23)个月。两组患者的平均疼痛缓解、活动范围、力量和Constant评分均有显著改善。术后两组间未发现统计学差异。根据对照影像学检查,A组的再撕裂率(23.4%)虽高于B组(17.1%),但差异无统计学意义。

结论

两种桥接修补技术均取得了成功的功能结果。在结构结果方面,无结缝合带桥接结构的再撕裂率较低,但差异无统计学意义。需要更长时间的随访来证实这些结果并评估两种技术之间的潜在差异。

证据水平

前瞻性、非随机、对照研究III级。

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