Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
J Bone Joint Surg Am. 2013 Jun 5;95(11):965-71. doi: 10.2106/JBJS.L.00708.
Failure of tendon healing after a rotator cuff repair is demonstrated by magnetic resonance imaging (MRI) as a fluid-filled defect within the tendon. The frequency of, and factors associated with, failure of the tendon repair to heal have been the focus of many clinical studies. The timing of when these defects occur has not been previously studied in a large prospectively defined patient population, to our knowledge. It was our hypothesis that the majority of failures occur within twelve weeks after surgery.
One hundred and thirteen patients were enrolled in a multi-institutional prospective study. All patients had a standardized arthroscopic repair of a full-thickness tear of 1 to 4 cm as well as sequential MRI studies at six intervals from two weeks to fifty-two weeks. MRIs were reviewed at the time of imaging by the treating surgeon. Standardized patient-oriented clinical data were collected, physical examination was performed, and strength measurements were made preoperatively and postoperatively.
The treating surgeons diagnosed a recurrent tear with MRI in nineteen (17%) of the 113 patients within one year after surgery. The mean time to the retear was 19.2 weeks. There was a linear increase in retears over the first twenty-six weeks after surgery, and one additional tear was diagnosed between twenty-six and fifty-two weeks after repair.
Retears primarily occur between six and twenty-six weeks after arthroscopic rotator cuff repair, and few additional tears occur thereafter. A substantial number of retears occur between twelve and twenty-six weeks after repair.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
肩袖修复后肌腱愈合失败在磁共振成像（MRI）上表现为肌腱内充满液体的缺损。许多临床研究都集中在肌腱修复愈合失败的频率和相关因素上。据我们所知，这些缺陷发生的时间尚未在大型前瞻性定义的患者人群中进行过研究。我们的假设是，大多数失败发生在手术后十二周内。
113 名患者参加了一项多机构前瞻性研究。所有患者均接受了标准化的关节镜下全层撕裂 1 至 4cm 的修复，以及从术后两周到 52 周的六个时间点的连续 MRI 研究。在成像时由主治外科医生对 MRI 进行复查。收集了标准化的以患者为中心的临床数据，进行了体格检查，并在术前和术后进行了力量测量。
在术后一年，113 名患者中有 19 名（17%）经 MRI 诊断为复发性撕裂。再撕裂的平均时间为 19.2 周。术后前 26 周再撕裂呈线性增加，修复后 26 至 52 周又诊断出一例撕裂。
在关节镜肩袖修复后 6 至 26 周内主要发生再撕裂，此后很少发生其他撕裂。在修复后 12 至 26 周内发生了大量的再撕裂。
治疗水平 IV。有关证据水平的完整描述，请参阅作者说明。
