Department of Orthopedic Surgery, Jeju National University Hospital, Jeju, South Korea.
Department of Orthopaedic Surgery, Inha University School of Medicine, Incheon, South Korea.
J Shoulder Elbow Surg. 2014 Nov;23(11):1675-81. doi: 10.1016/j.jse.2014.02.021. Epub 2014 May 24.
This study was conducted to evaluate clinical outcomes, maintenance of repair integrity, and retear rate after arthroscopic rotator cuff repair by a suture bridge technique among patients with medium, large, and massive rotator cuff tears.
We evaluated 147 patients who had undergone arthroscopic rotator cuff repair. Clinical and functional evaluations were performed with the Constant and University of California-Los Angeles scores. All patients were confirmed to have magnetic resonance imaging evidence of tendon healing at least 12 months postoperatively.
The average postoperative time to follow-up magnetic resonance imaging was 23.4 months (range, 12-48 months). A total of 25 (17.0%) retears were observed. All clinical outcome scores were improved significantly at follow-up. Larger intraoperative tear sizes were correlated with higher retear rates. The incidence of retear was also higher in cases in which the preoperative fatty degeneration grade was higher. The incidence of retear increased with age and in the heavy worker group (e.g., farmers, carriers, car mechanics) but was not statistically significant.
Arthroscopic rotator cuff repair by a suture bridge technique yields improvements in clinical outcome measures and a relatively high degree of patient satisfaction despite the fact that repair integrity is not maintained in many cases.
本研究旨在评估关节镜下缝合桥技术修复中等、大、巨大肩袖撕裂的临床疗效、修复完整性的维持和再撕裂率。
我们评估了 147 例接受关节镜肩袖修复的患者。采用 Constant 和加利福尼亚大学洛杉矶评分系统进行临床和功能评估。所有患者术后至少 12 个月均经磁共振成像证实有肌腱愈合的证据。
平均术后随访磁共振成像时间为 23.4 个月（范围 12-48 个月）。共观察到 25 例（17.0%）再撕裂。所有临床疗效评分在随访时均显著改善。术中撕裂越大，再撕裂率越高。术前脂肪变性程度越高，再撕裂的发生率也越高。再撕裂的发生率随年龄和重体力劳动者（如农民、搬运工、汽车修理工）的增加而增加，但无统计学意义。
尽管关节镜下缝合桥技术修复肩袖撕裂后，许多病例的修复完整性无法维持，但仍能改善临床疗效指标，并获得较高的患者满意度。
