超声测定肩袖撕裂的可修复性。
Ultrasound determination of rotator cuff tear repairability.
作者信息
Tse Andrew K, Lam Patrick H, Walton Judie R, Hackett Lisa, Murrell George Ac
机构信息
The Orthopaedic Research Institute, Research & Education Centre, University of New South Wales, St George Hospital Campus, Kogarah, Sydney, NSW, Australia.
出版信息
Shoulder Elbow. 2016 Jan;8(1):14-21. doi: 10.1177/1758573215585284. Epub 2015 May 12.
BACKGROUND
Rotator cuff repair aims to reattach the torn tendon to the greater tuberosity footprint with suture anchors. The present study aimed to assess the diagnostic accuracy of ultrasound in predicting rotator cuff tear repairability and to assess which sonographic and pre-operative features are strongest in predicting repairability.
METHODS
The study was a retrospective analysis of measurements made prospectively in a cohort of 373 patients who had ultrasounds of their shoulder and underwent rotator cuff repair. Measurements of rotator cuff tear size and muscle atrophy were made pre-operatively by ultrasound to enable prediction of rotator cuff repairability. Tears were classified following ultrasound as repairable or irreparable, and were correlated with intra-operative repairability.
RESULTS
Ultrasound assessment of rotator cuff tear repairability has a sensitivity of 86% (p < 0.0001) and a specificity of 67% (p < 0.0001). The strongest predictors of rotator cuff repairability were tear size (p < 0.001) and age (p = 0.004). Sonographic assessments of tear size ≥4 cm(2) or anteroposterior tear length ≥25 mm indicated an irreparable rotator cuff tear.
CONCLUSIONS
Ultrasound assessment is accurate in predicting rotator cuff tear repairability. Tear size or anteroposterior tear length and age were the best predictors of repairability.
背景
肩袖修复旨在使用缝合锚钉将撕裂的肌腱重新附着到大结节足迹处。本研究旨在评估超声在预测肩袖撕裂可修复性方面的诊断准确性，并评估哪些超声和术前特征在预测可修复性方面最为有力。
方法
本研究是一项回顾性分析，对373例肩部接受超声检查并进行肩袖修复的患者队列进行了前瞻性测量。术前通过超声测量肩袖撕裂大小和肌肉萎缩情况，以预测肩袖撕裂的可修复性。根据超声检查结果，将撕裂分为可修复或不可修复，并与术中可修复性进行关联。
结果
超声评估肩袖撕裂可修复性的敏感性为86%（p < 0.0001），特异性为67%（p < 0.0001）。肩袖可修复性的最强预测因素是撕裂大小（p < 0.001）和年龄（p = 0.004）。超声评估撕裂大小≥4 cm²或前后径撕裂长度≥25 mm表明肩袖撕裂不可修复。
结论
超声评估在预测肩袖撕裂可修复性方面准确。撕裂大小或前后径撕裂长度以及年龄是可修复性的最佳预测因素。
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