Natera Luis, Consigliere Paolo, Witney-Lagen Caroline, Brugera Juan, Sforza Giuseppe, Atoun Ehud, Levy Ofer
Reading Shoulder Unit, Royal Berkshire Hospital and Berkshire Independent Hospital Reading, Berkshire, United Kingdom.
Hospital San Juan de Dios Pamplona, Pamplona (Navarra), Spain.
Arthrosc Tech. 2017 Oct 16;6(5):e1903-e1909. doi: 10.1016/j.eats.2017.07.010. eCollection 2017 Oct.
Many techniques of arthroscopic rotator cuff repair have been described. No significant differences in clinical outcomes or rerupture rates have been observed when comparing single-row with double-row methods. Not all single- and double-row repairs are the same. The details of the technique used are crucial. It has been shown that the suture-tendon interface is the weakest point of the reconstruction. Therefore, the biomechanical properties of rotator cuff repairs might be influenced more by the suture configuration than by the number of anchors or by the number of rows involved. Techniques that secure less amount of tendon over a smaller area of the healing zone might be expected to have higher failure rates. The way the sutures of the "parachute technique" are configured represents a quadruple mattress that increases the contact and pressure between the tendon and its footprint and increases the primary load to failure of the repair. We present a simple and effective single-row technique that involves the biomechanical and biological advantages related to the increased contact area and pressure between the cuff and its footprint.
已经描述了许多关节镜下肩袖修复技术。比较单排和双排方法时，未观察到临床结果或再破裂率有显著差异。并非所有单排和双排修复都是相同的。所使用技术的细节至关重要。已经表明，缝线-肌腱界面是重建的最薄弱点。因此，肩袖修复的生物力学特性可能更多地受缝线构型的影响，而不是受锚钉数量或排数的影响。在愈合区较小面积上固定较少肌腱量的技术可能预期有较高的失败率。“降落伞技术”的缝线构型方式代表一种四重褥式缝合，可增加肌腱与其附着点之间的接触和压力，并增加修复的初始失效负荷。我们提出一种简单有效的单排技术，该技术具有与肩袖及其附着点之间增加的接触面积和压力相关的生物力学和生物学优势。
