Boutsiadis Achilleas, Chen Shiyi, Jiang Chunyan, Lenoir Hubert, Delsol Philippe, Barth Johannes
Department of Orthopaedic Surgery, Centre Osteoarticulaire des Cèdres, Grenoble, France.
Department of Orthopedic Sports Medicine, Huashan Hospital, Fudan University Sports Medicine Center, Shanghai, China.
Arthrosc Tech. 2017 Oct 12;6(5):e1559-e1566. doi: 10.1016/j.eats.2017.06.030. eCollection 2017 Oct.
Massive irreparable rotator cuff tears remain a challenging condition during daily clinical practice. Irreversible fatty infiltration of muscles and excessive chronic retraction of tendons predispose to high failure rates of their surgical treatment. Superior capsular reconstruction with either fascia lata autograft or a dermal allograft patch is a newly described solution that could prevent superior humeral head migration and restore the anteroposterior shoulder muscle force couples. The purpose of this article is to propose a technical modification of superior capsular reconstruction using long head of the biceps tendon autograft. The tendon's insertion into the glenoid is left intact, whereas laterally, it is tenotomized, transferred, and sutured with anchors onto the footprint of the supraspinatus tendon acting as a superior static stabilizer of the shoulder joint. Although this surgical modification has theoretical biological advantages, could be performed with the least technical demands, and simplifies the original demanding procedure, further prospective studies with large cohort populations and long-term follow-up are necessary to establish its effectiveness.
在日常临床实践中，巨大且无法修复的肩袖撕裂仍然是一个具有挑战性的病症。肌肉不可逆转的脂肪浸润和肌腱过度慢性回缩导致其手术治疗的高失败率。使用阔筋膜自体移植或真皮同种异体移植补片进行上盂唇重建是一种新描述的解决方案，可防止肱骨头向上移位并恢复肩前后部肌肉力偶。本文的目的是提出一种使用肱二头肌长头肌腱自体移植对上盂唇重建进行技术改良的方法。肌腱在关节盂的附着点保持完整，而在外侧，将其切断、转移并用锚钉缝合到作为肩关节上静态稳定器的冈上肌腱足迹上。尽管这种手术改良具有理论生物学优势，技术要求最低，且简化了原本要求苛刻的手术过程，但仍需要进一步开展大样本队列人群的前瞻性研究和长期随访，以确定其有效性。
