Barnes L A Fink, Kim H M, Caldwell J-M, Buza J, Ahmad C S, Bigliani L U, Levine W N
Temple University School of Medicine, Philadelphia, PA, USA.
Penn State University Medical Center, Hershey, PA, USA.
Bone Joint J. 2017 Feb;99-B(2):245-249. doi: 10.1302/0301-620X.99B2.BJJ-2016-0055.R1.
Advances in arthroscopic techniques for rotator cuff repair have made the mini-open approach less popular. However, the mini-open approach remains an important technique for repair for many surgeons. The aims of this study were to compare the integrity of the repair, the function of the shoulder and satisfaction post-operatively using these two techniques in patients aged > 50 years.
We identified 22 patients treated with mini-open and 128 patients treated with arthroscopic rotator cuff repair of July 2007 and June 2011. The mean follow-up was two years (1 to 5). Outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores, and satisfaction. The integrity of the repair was assessed using ultrasonography. A power analysis ensured sufficient enrolment.
There was no statistically significant difference between the age, function, satisfaction, or pain scores (p > 0.05) of the two groups. The integrity of the repair and the mean SST scores were significantly better in the mini-open group (91% of mini-open repairs were intact versus 60% of arthroscopic repairs, p = 0.023; mean SST score 10.9 (standard deviation (sd) 1.3) in the mini-open group; 8.9 (sd 3.5) in arthroscopic group; p = 0.003). The ASES scores were also higher in the mini-open group (mean ASES score 91.0 (sd 10.5) in mini-open group; mean 82.70 (sd 19.8) in the arthroscopic group; p = 0.048).
The integrity of the repair and function of the shoulder were better after a mini-open repair than after arthroscopic repair of a rotator cuff tear in these patients. The functional difference did not translate into a difference in satisfaction. Mini-open rotator cuff repair remains a useful technique despite advances in arthroscopy. Cite this article: Bone Joint J 2017;99-B:245-9.
用于肩袖修复的关节镜技术的进步已使小切口开放手术不再那么受欢迎。然而，对于许多外科医生而言，小切口开放手术仍是一种重要的修复技术。本研究的目的是比较采用这两种技术治疗年龄大于50岁患者的术后修复完整性、肩部功能及满意度。
我们确定了2007年7月至2011年6月间接受小切口开放手术治疗的22例患者和接受关节镜下肩袖修复的128例患者。平均随访时间为两年（1至5年）。采用美国肩肘外科医师协会（ASES）评分、简易肩部测试（SST）评分及满意度来评估结果。通过超声检查评估修复的完整性。一项功效分析确保了足够的入组人数。
两组患者的年龄、功能、满意度或疼痛评分之间无统计学显著差异（p>0.05）。小切口开放组的修复完整性及平均SST评分明显更好（小切口开放修复的完整率为91%，而关节镜修复为60%，p=0.023；小切口开放组的平均SST评分为10.9（标准差（sd）1.3）；关节镜组为8.9（sd 3.5）；p=0.003）。小切口开放组的ASES评分也更高（小切口开放组的平均ASES评分为91.0（sd 10.5）；关节镜组平均为82.70（sd 19.8）；p=0.048）。
在这些患者中，肩袖撕裂进行小切口开放修复后的修复完整性及肩部功能优于关节镜修复。功能上的差异并未转化为满意度的差异。尽管关节镜技术有所进步，但小切口开放肩袖修复仍是一种有用的技术。引用本文：《骨与关节杂志》2017年；99-B：245-249。
