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关节镜下使用全缝线型、生物可吸收型和 PEEK 型锚钉修复肩袖撕裂后盂肱下囊的形成。

Perianchor Cyst Formation After Arthroscopic Rotator Cuff Repair Using All-Suture-Type, Bioabsorbable-Type, and PEEK-Type Anchors.

机构信息

Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

Arthroscopy. 2019 Aug;35(8):2284-2292. doi: 10.1016/j.arthro.2019.03.032. Epub 2019 Jul 23.

Abstract

PURPOSE

This study aimed to identify the difference in postoperative perianchor bone reactions in different groups of patients who underwent rotator cuff tear repairs with all-suture-, bioabsorbable screw-, and PEEK (polyether ether ketone)-type suture anchors. Furthermore, the rate of rotator cuff retear and its association with perianchor bone reactions based on the different anchors used were investigated. Moreover, their impact on the clinical outcome of patients was examined.

METHODS

The study included 213 patients who underwent arthroscopic single-row repair and were divided into 3 groups according to the suture anchor used: all-suture (n = 137), biodegradable (n = 36), and PEEK (n = 40) anchor groups. The clinical outcomes and magnetic resonance imaging findings were evaluated at a mean follow-up of 9.6 months. The perianchor bone reaction at the anchor site was categorized according to grades. Patients were classified based on repair integrity into the healed and retear groups with Sugaya type I to III and Sugaya type IV to V, respectively.

RESULTS

No statistically significant differences in Constant scores and retear rates were observed between the groups (P = .934 and P = .548, respectively). Magnetic resonance imaging showed that the total number of perianchor cysts formed postoperatively was 23 (10.8% [23 of 213 patients]). Moreover, the proportions of perianchor cysts were 8.8%, 16.7%, and 12.5% in the all-suture-type, bioabsorbable-, and PEEK-type anchor groups, respectively (P = .485). In the retear group, the incidence rate was significantly increased with higher grades of perianchor bone reaction (P = .001). The tear size and perianchor bone reaction were found to be independent factors that affected the incidence of retear.

CONCLUSIONS

Perianchor cyst formation was observed in 10.8% of cases after the use of suture anchors for arthroscopic rotator cuff repair. No significant differences were observed among all-suture-type, bioabsorbable-type, and PEEK-type anchors in terms of visual analog scale and Constant scores, retear rates, and perianchor bone reactions. However, the retear rate was associated with a greater perianchor cystic reaction and larger tear size.

LEVEL OF EVIDENCE

Level III, retrospective comparative trial.

摘要

目的

本研究旨在比较不同类型锚钉(全缝线锚钉、生物可吸收螺钉和 PEEK 缝线锚钉)修复肩袖撕裂患者的术后锚钉周围骨反应的差异。进一步研究基于不同锚钉使用的肩袖再撕裂率及其与锚钉周围骨反应的关系。同时,评估它们对患者临床结果的影响。

方法

本研究纳入 213 例行关节镜下单排修复的患者,根据使用的缝合锚钉分为 3 组:全缝线(n=137)、生物可吸收(n=36)和 PEEK(n=40)锚钉组。在平均 9.6 个月的随访中,评估临床结果和磁共振成像发现。根据等级对锚钉部位的锚钉周围骨反应进行分类。根据修复完整性,患者分为愈合组和再撕裂组,Sugaya 类型 I 至 III 型为愈合组,Sugaya 类型 IV 至 V 型为再撕裂组。

结果

各组间 Constant 评分和再撕裂率无统计学差异(P=0.934 和 P=0.548)。磁共振成像显示术后共形成 23 个锚钉周围囊肿(213 例患者中的 10.8%)。此外,全缝线型、生物可吸收型和 PEEK 型锚钉组的锚钉周围囊肿比例分别为 8.8%、16.7%和 12.5%(P=0.485)。再撕裂组中,随着锚钉周围骨反应程度的增加,再撕裂发生率显著增加(P=0.001)。撕裂大小和锚钉周围骨反应被发现是影响再撕裂发生率的独立因素。

结论

关节镜肩袖修复中使用缝合锚钉后,10.8%的病例出现锚钉周围囊肿。全缝线型、生物可吸收型和 PEEK 型锚钉在视觉模拟评分和 Constant 评分、再撕裂率和锚钉周围骨反应方面无显著差异。然而,再撕裂率与更大的锚钉周围囊性反应和更大的撕裂大小相关。

证据等级

III 级,回顾性比较试验。

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