Connelly Tara M, Shaw Aileen, O'Grady Paul
Division of Trauma and Orthopaedic Surgery, Mayo General Hospital, Castlebar, Co Mayo, Ireland.
Int Orthop. 2015 Jun;39(6):1109-14. doi: 10.1007/s00264-015-2720-z. Epub 2015 Mar 12.
The aim of the present study was to evaluate functional and quality of life outcomes after transosseous equivalent (TOE) double row suture technique for massive rotator cuff (RTC) tear repair using validated subjective and objective measures. This technique has shown promising preliminary results in RTC repair; however, a paucity of evidence regarding these outcomes in massive RTC (MRTC) tear repair exists.
Patients were identified using the Hospital Inpatient Enquiry Scheme. Pre-operative MRI and medical records were reviewed. A massive RTC tear was defined as the detachment of two or more tendons from their point of insertion on the humeral head. The Constant and Oxford Shoulder Scores (OSS) and SF-12 questionnaire were used for evaluation.
Twenty-two patients were studied (72.7 % male; mean age at surgery, 62.6 years). Mean follow up was 14 (range six to 30) months. At six weeks postoperatively, 68 % achieved good or excellent shoulder function as measured by the OSS and Constant score. The cohort's mean SF-12 physical and emotional scores were significantly lower (p = 0.0002 and 0.037) and the vitality and mental health scores were higher (p = 0.005 and 0.006) than the reference norm scores.
The TOE double row surgical repair for MRTC tears provides good to excellent functional outcomes and is associated with high vitality and mental health scores at a mean of 14 months. Physical and emotional scores were lower than reference norm. These results suggest this repair technique is appropriate for massive rotator cuff tears, and future randomised control studies are warranted.
本研究旨在使用经过验证的主观和客观测量方法,评估经骨等效(TOE)双排缝合技术修复巨大肩袖(RTC)撕裂后的功能和生活质量结果。该技术在RTC修复中已显示出有前景的初步结果;然而,关于巨大RTC(MRTC)撕裂修复中这些结果的证据很少。
使用医院住院患者查询计划识别患者。回顾术前MRI和病历。巨大RTC撕裂定义为两条或更多肌腱从其在肱骨头的附着点处分离。使用Constant和牛津肩部评分(OSS)以及SF-12问卷进行评估。
研究了22例患者(72.7%为男性;手术时平均年龄62.6岁)。平均随访14(范围6至30)个月。术后六周,通过OSS和Constant评分测量,68%的患者肩部功能达到良好或优秀。该队列的平均SF-12身体和情感评分显著更低(p = 0.0002和0.037),活力和心理健康评分更高(p = 0.005和0.006),高于参考标准评分。
TOE双排手术修复MRTC撕裂可提供良好至优秀的功能结果,并且在平均14个月时与高活力和心理健康评分相关。身体和情感评分低于参考标准。这些结果表明这种修复技术适用于巨大肩袖撕裂,未来有必要进行随机对照研究。