Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessalia, Larissa, Greece.
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Am J Sports Med. 2018 Jan;46(1):116-121. doi: 10.1177/0363546517728718. Epub 2017 Sep 25.
When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success. Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and double-row (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid- to long-term clinical outcomes.
Cohort study; Level of evidence, 2.
A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya's classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years.
Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [ P < .05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [ P < .05]; Constant score, 94 and 76, respectively [ P < .05]).
The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.
当对年轻患者进行关节镜下肩袖修复时,需要持久的结构和功能的肌腱完整性。对于年轻人群,应考虑采用潜在提供更好肌腱愈合的固定技术,以实现长期的临床成功。
假设/目的:本研究旨在比较 55 岁以下患者关节镜下肩袖修复中单排和双排(即缝线桥接)固定技术的放射学和临床中期结果。我们假设双排技术将导致更好的肌腱愈合,从而带来更好的中期至长期临床结果。
队列研究;证据等级,2 级。
连续纳入了 66 例年龄均小于 55 岁、存在中等至大的冈上肌和冈下肌全层撕裂的患者,所有患者均接受关节镜下单排或双排(即缝线桥接)修复,并进行前瞻性观察。34 例和 32 例患者分别被分配至单排和双排组。术后至少 12 个月,根据 Sugaya 分类通过 MRI 评估肌腱完整性,至少 2 年时通过加州大学洛杉矶分校(UCLA)评分和Constant 评分评估临床结果。
平均随访时间为 46 个月(范围,28-50 个月)。双排组的肌腱愈合率高于单排组(分别为 84%和 61%,P <.05)。尽管两种技术的评分结果无差异,但与肌腱再撕裂的患者相比,愈合的肌腱患者的临床结果更好(UCLA 评分分别为 34.2 和 27.6,P <.05;Constant 评分分别为 94 和 76,P <.05)。
与单排修复技术相比,双排修复技术可能提供更好的肌腱愈合。对于中等至大肩袖撕裂的 55 岁以下患者,应考虑双排修复。