Micic Ivan, Kholinne Erica, Kwak Jae-Man, Koh Kyoung-Hwan, Jeon In-Ho
Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Nis, Niš, Serbia.
Department of Orthopedic Surgery, St. Carolus Hospital, Indonesia; Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Acta Orthop Traumatol Turc. 2019 Nov;53(6):414-419. doi: 10.1016/j.aott.2019.08.015. Epub 2019 Sep 25.
The objective of this study was to evaluate the incidence of osteolysis around the bioabsorbable and nonabsorbable anchors using serial magnetic resonance imaging (MRI) and to determine the relationship between osteolysis and the retear rate after arthroscopic rotator cuff repair.
From July 2012 to July 2014, 50 patients [28 men and 22 women; mean age, 56.4 (range: 45-56) years] underwent arthroscopic rotator cuff repair for a medium-to large-size tear with double-row suture-bridge technique. The bioabsorbable anchors used in the medial row comprised hydroxyapatite-polylactic acid enantiomer, and the nonabsorbable anchors in the lateral row were polyetheretherketone (PEEK)-type anchors. All patients underwent MRI evaluation at 3, 6, and 12 months postoperatively to determine osteolysis and identify any retear.
The incidences of osteolysis at 3, 6, and 12 months postoperatively were 1%, 4%, and 6% with nonabsorbable anchors and 13%, 29%, and 39% with bioabsorbable anchors, respectively. The incidences of osteolysis were significantly higher with the bioabsorbable anchors than with the nonabsorbable anchors (P < 0.005 for all three follow-ups). There was no significant difference between osteolysis and non-osteolysis groups regarding the retear rate or retear size (P = 0.189 and 0.069, respectively).
Osteolysis was common around bioabsorbable anchors used for arthroscopic rotator cuff repair, and it also occurred around the PEEK-type nonabsorbable anchors. The incidence of osteolysis of nonabsorbable anchors was significantly lower than that of bioabsorbable anchors. Osteolysis did not significantly affect rotator cuff retear after arthroscopic repair with either bioabsorbable or nonabsorbable anchors.
Level III, Therapeutic Study.
本研究的目的是使用连续磁共振成像(MRI)评估生物可吸收和不可吸收锚钉周围骨溶解的发生率,并确定关节镜下肩袖修复术后骨溶解与再撕裂率之间的关系。
2012年7月至2014年7月,50例患者[28例男性和22例女性;平均年龄56.4岁(范围:45 - 56岁)]采用双排缝线桥技术接受关节镜下肩袖修复,治疗中至大型撕裂伤。内侧排使用的生物可吸收锚钉为羟基磷灰石 - 聚乳酸对映体,外侧排的不可吸收锚钉为聚醚醚酮(PEEK)型锚钉。所有患者在术后3、6和12个月接受MRI评估,以确定骨溶解情况并识别任何再撕裂。
术后3、6和12个月时,不可吸收锚钉周围骨溶解的发生率分别为1%、4%和6%,生物可吸收锚钉周围骨溶解的发生率分别为13%、29%和39%。生物可吸收锚钉周围骨溶解的发生率显著高于不可吸收锚钉(所有三次随访P < 0.005)。在再撕裂率或再撕裂大小方面,骨溶解组与非骨溶解组之间无显著差异(分别为P = 0.189和0.069)。
关节镜下肩袖修复使用的生物可吸收锚钉周围骨溶解常见,聚醚醚酮型不可吸收锚钉周围也会发生骨溶解。不可吸收锚钉的骨溶解发生率显著低于生物可吸收锚钉。骨溶解对使用生物可吸收或不可吸收锚钉进行关节镜修复后的肩袖再撕裂无显著影响。
III级,治疗性研究。