Elkins Ashleigh, Lam Patrick H, Murrell George A C
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, Australia.
Orthop J Sports Med. 2019 Aug 21;7(8):2325967119864088. doi: 10.1177/2325967119864088. eCollection 2019 Aug.
Arthroscopic rotator cuff repair is a common but technically difficult surgical technique. This study describes a novel arthroscopic rotator cuff repair technique where the repair was performed while visualized entirely from the glenohumeral joint. A single-row knotless tension band inverted mattress suture technique was utilized with fixation obtained via suture anchors. The technique was relatively easy to perform and demonstrated good repair strength and footprint compression in an ex vivo ovine model.
To evaluate the safety and efficacy of this technique in 1000 consecutive patients.
Case series; Level of evidence, 4.
This study was a retrospective analysis of prospectively collected data in 1000 consecutive patients. Included patients underwent primary arthroscopic rotator cuff repair by a single surgeon performing the undersurface repair technique and attended 6-month follow-up with ultrasound evaluation to determine repair integrity. Exclusion criteria were irreparable tears, incomplete repairs, tendon reconstruction with a synthetic patch, and revision cases.
The only complication was retear. The overall retear rate at 6 months following repair with the undersurface technique was 8.5%. The mean ± SEM operative time for the technique was 16 ± 0.3 minutes (range, 4-75 minutes). There were no infections. Smaller tears were repaired faster and had better healing rates.
The novel all-inside arthroscopic rotator cuff repair technique was safe and significantly faster and provided better healing rates than other repair techniques. The retear rate of 8.5% is, to the authors' knowledge, the lowest reported rotator cuff retear rate in a large cohort of patients based on a single technique.
关节镜下肩袖修复是一种常见但技术上具有挑战性的手术技术。本研究描述了一种新型的关节镜下肩袖修复技术，该修复手术完全在盂肱关节内可视化操作下进行。采用单排无结张力带倒刺褥式缝合技术，并通过缝合锚钉进行固定。该技术操作相对简便，并且在体外绵羊模型中显示出良好的修复强度和对肩袖附着点的压缩效果。
评估该技术在1000例连续患者中的安全性和有效性。
病例系列研究；证据等级，4级。
本研究是对1000例连续患者前瞻性收集数据的回顾性分析。纳入的患者由同一位外科医生采用关节镜下肩袖下表面修复技术进行初次肩袖修复，并接受为期6个月的随访，通过超声评估来确定修复的完整性。排除标准为不可修复的撕裂、不完全修复、使用合成补片进行肌腱重建以及翻修病例。
唯一的并发症是再撕裂。采用下表面修复技术修复后6个月时的总体再撕裂率为8.5%。该技术的平均手术时间±标准误为16±0.3分钟（范围为4 - 75分钟）。无感染发生。较小的撕裂修复速度更快且愈合率更好。
这种新型的全关节镜下肩袖修复技术安全，且明显比其他修复技术更快，愈合率更高。据作者所知，8.5%的再撕裂率是基于单一技术的大量患者队列中报道的最低肩袖再撕裂率。
