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关节侧不完全修复会增加全层肩袖撕裂的再撕裂率。

Incomplete articular-side repair increase re-tear rate in full-thickness rotator cuff tears.

作者信息

Kim Kyung Cheon, Lee Woo-Yong, Shin Hyun Dae, Han Sun-Cheol

机构信息

1 Shoulder Center, Department of Orthopedic Surgery, TanTan Hospital, Daejeon, South Korea.

2 Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, South Korea.

出版信息

J Orthop Surg (Hong Kong). 2018 Jan-Apr;26(1):2309499018760113. doi: 10.1177/2309499018760113.

Abstract

PURPOSE

This study compared the functional outcome and repair integrity of arthroscopic rotator cuff repair according to articular-side repair state in full-thickness tears.

METHODS

We prospectively enrolled 80 consecutive patients with full-thickness rotator cuff tears of 1.5-3.5 cm at the anterior to posterior dimension. These patients were divided into two groups according to intraoperative articular-side repair state during operation: complete and incomplete repair groups. Repair integrity was evaluated at 6 months after the operation by magnetic resonance image or ultrasonography. Clinical outcomes were evaluated at 1 year and 2 years postoperatively. Four outcome measures were used in this study: visual analog scale pain score, American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score, and range of motion.

RESULTS

At 2-year follow-up, the average UCLA, ASES, and constant score improved significantly to 32.46, 87.94, and 79.69, respectively, in the complete group and to 32.50, 87.65, and 78.92, respectively, in the incomplete group. The UCLA, ASES, and constant score improved in both groups postoperatively (all ps < 0.000); however, there was no significant difference between the two groups ( p = 0.960, 0.921, and 0.796, respectively). The re-tear rate was 13.7% in the shoulders that underwent complete repair and 33.3% in the shoulders that underwent incomplete repair; this difference was statistically significant ( p = 0.041).

CONCLUSION

Regardless of the repair state of articular-side rotator cuff, the arthroscopic rotator cuff repair resulted in comparable functional outcomes between two groups at short-term follow-up. However, patients who repaired articular-side rotator cuff incompletely revealed higher re-tear rate after operation than those who repaired completely.

摘要

目的

本研究根据全层撕裂时关节侧修复状态,比较关节镜下肩袖修复的功能结果和修复完整性。

方法

我们前瞻性纳入了80例连续的患者,这些患者肩袖全层撕裂的前后径为1.5 - 3.5厘米。根据手术中关节侧修复状态,将这些患者分为两组:完全修复组和不完全修复组。术后6个月通过磁共振成像或超声评估修复完整性。术后1年和2年评估临床结果。本研究使用了四项结果指标:视觉模拟量表疼痛评分、美国肩肘外科医师(ASES)评分、加利福尼亚大学洛杉矶分校(UCLA)肩评分量表评分和活动范围。

结果

在2年随访时,完全修复组的平均UCLA、ASES和常数评分分别显著提高到32.46、87.94和79.69,不完全修复组分别为32.50、87.65和78.92。两组术后UCLA、ASES和常数评分均有所提高(所有p值<0.000);然而,两组之间无显著差异(p值分别为0.960、0.921和0.796)。完全修复的肩部再撕裂率为13.7%,不完全修复的肩部为33.3%;这种差异具有统计学意义(p = 0.041)。

结论

无论关节侧肩袖的修复状态如何,关节镜下肩袖修复在短期随访中两组功能结果相当。然而,关节侧肩袖修复不完全的患者术后再撕裂率高于完全修复的患者。

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