Petri Maximilian, Warth Ryan J, Horan Marilee P, Greenspoon Joshua A, Millett Peter J
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.
Steadman Philippon Research Institute, Vail, Colorado, U.S.A.
Arthroscopy. 2016 Sep;32(9):1752-60. doi: 10.1016/j.arthro.2016.01.037. Epub 2016 Apr 6.
To assess minimum 2-year clinical outcomes after open revision biologic patch augmentation in patients with massive rotator cuff retears who had deficient rotator cuff tendons with healthy rotator cuff muscles.
Patients with massive posterosuperior rotator cuff retears who underwent open revision rotator cuff repair with patch augmentation were identified from a surgical registry. Outcomes data collected included American Shoulder and Elbow Surgeons; Quick Disabilities of the Arm, Shoulder and Hand; Single Assessment Numeric Evaluation; and Short Form-12 Physical Component Summary scores along with postoperative patient satisfaction, and activity modification.
There were 10 men and 2 women (13 shoulders, 1 bilateral) with a mean age of 57 years (range, 26 to 68 years). All patients had at least one prior arthroscopic rotator cuff repair. After patch augmentation, there were no complications, no adverse reactions to the patch, and no patients required further surgery. One patient (7.7%) with 4 prior cuff repairs had a documented posterosuperior retear on magnetic resonance imaging 2 months after repair. Minimum 2-year outcome scores were available for 12 of 13 (92.3%) shoulders after a mean follow-up period of 2.5 years (range, 2.0 to 4.0 years). The ASES score improved by 21.5 points. Although the pain component of the ASES score and the total ASES score did not improve significantly, the function component of the ASES score improved significantly when compared with their preoperative baselines (P < .05). Median patient satisfaction at final follow-up was 9/10 (range, 2 to 10).
Biologic patch augmentation with human acellular dermal allograft was a safe and effective treatment method for patients with massive rotator cuff retears with deficient posterosuperior rotator cuff tendons in the presence of healthy rotator cuff muscles.
Level IV, therapeutic study.
评估在肩袖肌腱缺损但肩袖肌肉健康的巨大肩袖撕裂患者中，开放翻修生物补片增强术后至少2年的临床疗效。
从手术登记处识别出接受开放翻修肩袖修补并使用补片增强的巨大后上肩袖撕裂患者。收集的结果数据包括美国肩肘外科医师协会评分、手臂、肩部和手部快速残疾评估、单评估数字评价以及简明健康调查12项身体成分汇总评分，以及术后患者满意度和活动调整情况。
共有10名男性和2名女性（13个肩部，1例双侧），平均年龄57岁（范围26至68岁）。所有患者此前至少接受过一次关节镜下肩袖修补术。使用补片增强后，无并发症、对补片无不良反应，且无患者需要进一步手术。1例曾接受4次肩袖修补术的患者在修复后2个月的磁共振成像检查中发现有记录的后上再撕裂。平均随访2.5年（范围2.0至4.0年）后，13个肩部中有12个（92.3%）获得了至少2年的疗效评分。美国肩肘外科医师协会评分提高了21.5分。虽然美国肩肘外科医师协会评分的疼痛部分和总分没有显著改善，但与术前基线相比，美国肩肘外科医师协会评分的功能部分有显著改善（P <.05）。末次随访时患者满意度中位数为9/10（范围2至10）。
对于肩袖肌腱缺损但肩袖肌肉健康的巨大肩袖撕裂患者，同种异体脱细胞真皮生物补片增强术是一种安全有效的治疗方法。
IV级，治疗性研究。
