Mirzaee Fateme, Aslani Mohammad A, Zafarani Zohreh, Aslani Hamidreza
University of Social Welfare and Rehabilitation Sciences, Knee and Sport Medicine Research Center, Milad hospital, Tehran, Iran.
Knee and Sport Medicine Research Center, Milad hospital, Tehran, Iran.
Arch Bone Jt Surg. 2019 May;7(3):263-268.
The alternative surgery for massive and irreparable shoulder rotator cuff tears in older patients is the debridement of subacromial bursa, biceps tenotomy, and tuberoplasty (reverse acromioplasty). This study aimed to report the effectiveness of such a treatment performed arthroscopically in a small group of patients for a short period of time.
This prospective study was conducted on 12 patients with massive irreparable rotator cuff tear during 2014-2017. Participants with the mean age of 65 were subjected to arthroscopic debridement of subacromial bursa, necrotic rotator cuff tendon remnants, and tuberoplasty without coracoacromial ligament excision. The sign and symptoms of patients before and after the surgery were evaluated based on Modified-University of California at Los Angeles (UCLA) Shoulder Score.
With the mean follow-up of 18 months (12-24 months), the mean of the modified UCLA score improved from 9.2 to 27.5. The obtained results of the study revealed that the pain and range of motion improved to near normal in the participants. The functional outcome was good although there were a decrease of acromiohumeral distance from 5 to 4 mm and a slight increase in degenerative changes.
This simple arthroscopic procedure is recommended for massive irreparable rotator cuff tear, especially in elderly patients.
IV.
对于老年患者巨大且无法修复的肩袖撕裂，替代手术是肩峰下滑囊清创、肱二头肌切断术和结节成形术（反式肩峰成形术）。本研究旨在报告在一小群患者中短期内进行的这种关节镜治疗的有效性。
本前瞻性研究在2014年至2017年期间对12例巨大不可修复肩袖撕裂患者进行。平均年龄为65岁的参与者接受了关节镜下肩峰下滑囊清创、坏死的肩袖肌腱残余物清创以及不切除喙肩韧带的结节成形术。根据改良的加州大学洛杉矶分校（UCLA）肩部评分评估患者手术前后的体征和症状。
平均随访18个月（12 - 24个月），改良UCLA评分的平均值从9.2提高到27.5。研究结果显示，参与者的疼痛和活动范围改善至接近正常。尽管肩峰肱骨头距离从5毫米减少到4毫米，退变改变略有增加，但功能结果良好。
对于巨大不可修复的肩袖撕裂，尤其是老年患者，推荐这种简单的关节镜手术。
IV级。
