Mardani-Kivi Mohsen, Karimi Ali, Keyhani Sohrab, Hashemi-Motlagh Keyvan, Saheb-Ekhtiari Khashayar
a Department of Orthopaedics , Guilan University of Medical Sciences , Rasht , Iran.
b Orthopedic Department , Shahid-Beheshti University of Medical Sciences , Tehran , Iran.
Phys Sportsmed. 2016 Sep;44(3):274-7. doi: 10.1080/00913847.2016.1216717. Epub 2016 Aug 5.
Acromioplasty has been one of the most common techniques amongst orthopedic surgeries in the past decade. However, its efficacy in arthroscopic surgeries of rotator cuff repair is still debatable. The purpose of this study is to compare the arthroscopic rotator cuff repair with or without acromioplasty in patients with complete rotator cuff tear.
In this prospective cohort study, patients with complete rotator cuff tear (acromion type II or III Bigliani) and a history of failure to the conservative treatment for at least 6 months were evaluated for eligibility. Patients, based on the time interval, were placed in one of two groups: arthroscopic rotator cuff repair with (RCR-A group) and without acromioplasty (RCR group). Patients were assessed for two years in term of pain intensity by VAS criteria and shoulder functional status by Quick-DASH, Constant score and simple shoulder test criteria.
In the baseline assessment, RCR-A group (34 patients) and RCR group (33 patients) were similar. Comparing patients in two groups in relation to SST, Quick-DASH and VAS scores preoperatively showed there is no significant difference between the two groups. The SST, Quick-DASH and VAS scores improved significantly in both groups at both the 6-month and 2-year follow-ups (all P < 0.001). The extent of progress in the functional scores was similar in both groups (P > 0.05).
Arthroscopic rotator cuff repair without acromioplasty may be as reliable and useful as conventional rotator cuff repair with acromioplasty. Thus, acromioplasty cannot be recommended as a routine technique in every rotator cuff repair.
在过去十年中,肩峰成形术一直是骨科手术中最常用的技术之一。然而,其在关节镜下肩袖修复手术中的疗效仍存在争议。本研究的目的是比较在完全性肩袖撕裂患者中,进行或不进行肩峰成形术的关节镜下肩袖修复效果。
在这项前瞻性队列研究中,评估了完全性肩袖撕裂(II型或III型Bigliani肩峰)且保守治疗失败至少6个月的患者是否符合入选标准。根据时间间隔,将患者分为两组:进行肩峰成形术的关节镜下肩袖修复组(RCR - A组)和不进行肩峰成形术的关节镜下肩袖修复组(RCR组)。通过视觉模拟评分(VAS)标准评估患者两年的疼痛强度,并通过快速残疾评定量表(Quick - DASH)、Constant评分和简单肩部测试标准评估肩部功能状态。
在基线评估中,RCR - A组(34例患者)和RCR组(33例患者)相似。术前比较两组患者的简单肩部测试(SST)、Quick - DASH和VAS评分,发现两组之间无显著差异。在6个月和2年的随访中,两组的SST、Quick - DASH和VAS评分均显著改善(所有P < 0.001)。两组功能评分的改善程度相似(P > 0.05)。
不进行肩峰成形术的关节镜下肩袖修复可能与传统的进行肩峰成形术的肩袖修复一样可靠和有效。因此,不建议在每次肩袖修复中都将肩峰成形术作为常规技术。