Orthopaedic Research Institute (ORI), University of New South Wales, St George Hospital Campus, Sydney, New South Wales 2217, Australia.
Bone Joint Res. 2012 Sep 1;1(9):210-7. doi: 10.1302/2046-3758.19.2000072. Print 2012 Sep.
The aim of this study was to determine whether there is any significant difference in temporal measurements of pain, function and rates of re-tear for arthroscopic rotator cuff repair (RCR) patients compared with those patients undergoing open RCR.
This study compared questionnaire- and clinical examination-based outcomes over two years or longer for two series of patients who met the inclusion criteria: 200 open RCR and 200 arthroscopic RCR patients. All surgery was performed by a single surgeon.
Most pain measurements were similar for both groups. However, the arthroscopic RCR group reported less night pain severity at six months, less extreme pain and greater satisfaction with their overall shoulder condition than the open RCR group. The arthroscopic RCR patients also had earlier recovery of strength and range of motion, achieving near maximal recovery by six months post-operatively whereas the open RCR patients took longer to reach the same recovery level. The median operative times were 40 minutes (20 to 90) for arthroscopic RCR and 60 minutes (35 to 120) for open RCR. Arthroscopic RCR had a 29% re-tear rate compared with 52% for the open RCR group (p < 0.001).
Arthroscopic RCR involved less extreme pain than open RCR, earlier functional recovery, a shorter operative time and better repair integrity.
本研究旨在确定与行开放式肩袖修复术（ORCR）的患者相比，行关节镜下肩袖修复术（ARCR）的患者在疼痛、功能的时间测量以及再撕裂率方面是否存在显著差异。
本研究对符合纳入标准的两批患者（200 例接受开放式肩袖修复术和 200 例接受关节镜下肩袖修复术的患者）进行了长达两年或更长时间的问卷调查和临床检查。所有手术均由同一位外科医生完成。
两组患者的大多数疼痛测量结果相似。然而，ARCR 组在术后 6 个月时报告夜间疼痛严重程度较轻、极端疼痛较少、对整体肩部状况的满意度更高。ARCR 患者的力量和活动范围恢复更早，术后 6 个月即可接近完全恢复，而 ORCR 患者则需要更长时间才能达到相同的恢复水平。关节镜下肩袖修复术的中位手术时间为 40 分钟（20 至 90 分钟），而开放式肩袖修复术的中位手术时间为 60 分钟（35 至 120 分钟）。ARCR 的再撕裂率为 29%，而 ORCR 组为 52%（p<0.001）。
与 ORCR 相比，ARCR 涉及的极端疼痛较少，功能恢复更早，手术时间更短，修复完整性更好。
