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修复术后16年肩袖的结构完整性:尽管存在复发性撕裂,但仍有良好的长期预后。

Structural integrity of rotator cuff at 16 years following repair: good long-term outcomes despite recurrent tears.

作者信息

Elliott Robert S J, Lim Yi-Jia, Coghlan Jennifer, Troupis John, Bell Simon

机构信息

North Shore Hospital, Takapuna, Auckland, New Zealand.

Melbourne Shoulder and Elbow Centre, Brighton, Victoria, Australia.

出版信息

Shoulder Elbow. 2019 Feb;11(1):26-34. doi: 10.1177/1758573217738198. Epub 2017 Nov 10.

Abstract

BACKGROUND

There are few studies reporting long-term rotator cuff integrity following repair. The present study reports a case series of surgically repaired supraspinatus tendons followed up with clinical outcomes and ultrasound imaging after an average of 16 years.

METHODS

The prospectively studied clinical outcomes at short-, medium- and long-term follow-up in 27 shoulders in 25 patients treated with arthroscopic subacromial decompression and mini-open rotator cuff repair have been reported previously. The functional outcomes scores recorded were the University of California Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) measures. These patients then underwent an ultrasound scan with respect to the long-term assessment of the shoulder and the integrity of the repair.

RESULTS

A recurrent tear was noted in 37% of patients at 16.25 years after surgery, of which 50% were small. Two patients required repeat surgery. Patients had a mean UCLA score of 30, an ASES score of 91.3 and a SST score of 9.5 with a 85% level of satisfaction with surgery. Patients with a recurrent tear had outcome scores equivalent to those with an intact cuff with no significant pain. No independent risk factors were identified as predictors for recurrent tear.

CONCLUSIONS

Patients showed sustained benefit and satisfaction at long-term follow-up despite a 37% recurrence of full-thickness supraspinatus tear.

摘要

背景

很少有研究报告肩袖修复后的长期完整性情况。本研究报告了一系列手术修复冈上肌腱的病例,平均随访16年后观察其临床结果及超声影像情况。

方法

先前已报道过对25例患者的27个肩部进行关节镜下肩峰下减压和小切口肩袖修复治疗后的短期、中期和长期随访的前瞻性临床结果。记录的功能结果评分包括加州大学洛杉矶分校(UCLA)、美国肩肘外科医师学会(ASES)和简单肩部测试(SST)指标。这些患者随后接受了超声扫描,以对肩部进行长期评估及评估修复的完整性。

结果

术后16.25年,37%的患者出现复发性撕裂,其中50%为小撕裂。2例患者需要再次手术。患者的UCLA平均评分为30分,ASES评分为91.3分,SST评分为9.5分,对手术的满意度为85%。复发性撕裂患者的结果评分与肩袖完整且无明显疼痛的患者相当。未发现独立的风险因素可作为复发性撕裂的预测指标。

结论

尽管冈上肌腱全层撕裂的复发率为37%,但患者在长期随访中仍显示出持续的获益和满意度。

相似文献

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Identification of a genetic variant associated with rotator cuff repair healing.与肩袖修复愈合相关的基因变异的鉴定。
J Shoulder Elbow Surg. 2016 Jun;25(6):865-72. doi: 10.1016/j.jse.2016.02.019. Epub 2016 Apr 8.
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Prognostic factors influencing the outcome of rotator cuff repair: a systematic review.影响肩袖修复结果的预后因素:一项系统评价。
Knee Surg Sports Traumatol Arthrosc. 2016 Dec;24(12):3809-3819. doi: 10.1007/s00167-015-3700-y. Epub 2015 Jul 22.
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Evidence of genetic variations associated with rotator cuff disease.与肩袖疾病相关的遗传变异的证据。
J Shoulder Elbow Surg. 2014 Feb;23(2):227-35. doi: 10.1016/j.jse.2013.07.053. Epub 2013 Oct 12.

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