Vinanti Giovanni Battista, Rossato Alberto, Scrimieri Daniele, Petrera Massimo
Gruppo Ospedaliero San Donato Foundation, Istituto Clinico San Rocco di Franciacorta, Via dei Sabbioni 24, 25050, Ome, Brescia, Italy.
Residency Program in Orthopaedic Surgery, University of Verona, Verona, Italy.
Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2151-2156. doi: 10.1007/s00167-015-3953-5. Epub 2016 Apr 22.
To evaluate the outcomes of arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion (PASTA) in a large study group.
A retrospective review of prospectively collected data was conducted. One hundred and eighteen patients with PASTA lesion (grade A2-A3) who underwent arthroscopic transtendon repair were identified, of which 110 were eligible for the study. Ten patients were lost at final follow-up leaving a study group of 100 patients (52 male, 48 female). The average follow-up was 37 months (minimum 24 months, range 24-50, median 40). Mean age at the time of surgery was 50.4 (range 17-71, median 45). Patients were assessed before surgery and at 24-month follow-up, using the Simple Shoulder Test (SST), UCLA shoulder rating scale and the visual analogue scale (VAS). ROM was measured bilaterally and was evaluated before surgery, at 3-, 6- and 24-month follow-up. The satisfaction rate was calculated. Data were analysed using a paired Student's t test with 95 % confidence interval (significance p < 0.05).
Significant improvement in UCLA, SST and VAS score was observed. Fifty-four cases were rated excellent, 42 good, 2 fair, 2 poor according to the UCLA score. No significant differences in ROM were noted compared to the contra-lateral side (p < 0.001) at the 24-month follow-up. Eighteen patients presented with a stiff shoulder at the 3-month follow-up, but they recovered full ROM by the 6-month follow-up evaluation.
The arthroscopic transtendon repair of partial articular-sided rotator cuff tears is an effective procedure that leads to significant improvement in pain and shoulder function, with high patients' satisfaction rate, while the complication rate is low. This study demonstrated the effectiveness and safety of this technique in a large homogeneous study group.
IV.
在一个大型研究组中评估关节镜下经肌腱修复部分关节面侧冈上肌腱撕脱（PASTA）的疗效。
对前瞻性收集的数据进行回顾性分析。确定118例接受关节镜下经肌腱修复的PASTA损伤（A2 - A3级）患者，其中110例符合研究条件。10例患者在最终随访时失访，最终研究组为100例患者（男52例，女48例）。平均随访37个月（最短24个月，范围24 - 50个月，中位数40个月）。手术时的平均年龄为50.4岁（范围17 - 71岁，中位数45岁）。术前及24个月随访时，采用简单肩关节试验（SST）、加州大学洛杉矶分校（UCLA）肩关节评分量表和视觉模拟量表（VAS）对患者进行评估。双侧测量活动度（ROM），并在术前、3个月、6个月和24个月随访时进行评估。计算满意率。采用配对t检验分析数据，置信区间为95%（显著性p < 0.05）。
观察到UCLA、SST和VAS评分有显著改善。根据UCLA评分，54例为优，42例为良，2例为中，2例为差。在24个月随访时，与对侧相比，ROM无显著差异（p < 0.001）。18例患者在3个月随访时出现肩关节僵硬，但在6个月随访评估时恢复了完全的ROM。
关节镜下经肌腱修复部分关节面侧肩袖撕裂是一种有效的手术方法，可显著改善疼痛和肩关节功能，患者满意率高，并发症发生率低。本研究在一个大型同质性研究组中证明了该技术的有效性和安全性。
IV级。
