Gwak Heui-Chul, Kim Chang-Wan, Kim Jung-Han, Choo Hye-Jeung, Sagong Seung-Yeob, Shin John
Department of Orthopaedics, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
Department of Orthopaedics, Busan Paik Hospital, College of Medicine, Inje University, Busan, South Korea.
J Shoulder Elbow Surg. 2015 May;24(5):719-26. doi: 10.1016/j.jse.2014.09.027. Epub 2014 Oct 25.
The purpose of this study was to evaluate the extension of delamination and the cuff integrity after arthroscopic repair of delaminated rotator cuff tears.
Sixty-five patients with delaminated rotator cuff tears were retrospectively reviewed. The delaminated tears were divided into full-thickness delaminated tears and partial-thickness delaminated tears. To evaluate the medial extension, we calculated the coronal size of the delaminated portion. To evaluate the posterior extension, we checked the tendon involved. Cuff integrity was evaluated by computed tomography arthrography.
The mean medial extension in the full-thickness and partial-thickness delaminated tears was 18.1 ± 6.0 mm and 22.7 ± 6.3 mm, respectively (P = .0084). The posterior extension into the supraspinatus and the infraspinatus was 36.9% and 32.3%, respectively, in the full-thickness delaminated tears, and it was 27.7% and 3.1%, respectively, in the partial-thickness delaminated tears (P = .0043). With regard to cuff integrity, 35 cases of anatomic healing, 10 cases of partial healing defects, and 17 cases of retear were detected. Among the patients with retear and partial healing of the defect, all the partially healed defects showed delamination. Three retear patients showed delamination, and 14 retear patients did not show delamination; the difference was statistically significant (P = .0001).
The full-thickness delaminated tears showed less medial extension and more posterior extension than the partial-thickness delaminated tears. Delamination did not develop in retear patients, but delamination was common in the patients with partially healed defects.
本研究旨在评估关节镜下修复分层肩袖撕裂后的分层范围及袖带完整性。
回顾性分析65例分层肩袖撕裂患者。将分层撕裂分为全层分层撕裂和部分层分层撕裂。为评估内侧延伸范围，我们计算分层部分的冠状面大小。为评估后侧延伸范围，我们检查受累肌腱。通过计算机断层扫描关节造影评估袖带完整性。
全层分层撕裂和部分层分层撕裂的平均内侧延伸范围分别为18.1±6.0mm和22.7±6.3mm（P = 0.0084）。全层分层撕裂中延伸至上冈下肌和冈下肌的后侧延伸分别为36.9%和32.3%，部分层分层撕裂中分别为27.7%和3.1%（P = 0.0043）。关于袖带完整性，检测到35例解剖愈合、10例部分愈合缺陷和17例再撕裂。在再撕裂和部分愈合缺陷的患者中，所有部分愈合的缺陷均显示分层。17例再撕裂患者中有3例显示分层，14例未显示分层；差异有统计学意义（P = 0.0001）。
与部分层分层撕裂相比，全层分层撕裂的内侧延伸范围较小，后侧延伸范围较大。再撕裂患者未发生分层，但部分愈合缺陷的患者分层常见。
