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影响关节镜肩袖修复手术时间的因素:无结单排与经骨等效双排技术的比较。

Factors influencing operative time in arthroscopic rotator cuff repair: a comparison of knotless single-row vs. transosseous equivalent dual-row techniques.

机构信息

Emory University, Atlanta, GA, USA.

Emory University, Atlanta, GA, USA.

出版信息

J Shoulder Elbow Surg. 2020 Jul;29(7S):S48-S52. doi: 10.1016/j.jse.2019.10.015. Epub 2020 Jan 13.

Abstract

BACKGROUND

Despite the widespread use of arthroscopic rotator cuff repair (aRCR), there remains considerable debate on the benefits of a dual-row vs. a single-row (SR) repair technique. This study compares operative time of a knotless SR technique with transosseous equivalent (TOE) dual-row technique for aRCR and defines patient-specific factors that affect operative time.

METHODS

Data from 118 patients who underwent aRCR with a knotless SR technique was compared with data from 95 patients who underwent aRCR with a TOE technique by a single surgeon between 2014 and 2018. Baseline patient demographic information and operative time were recorded and compared between the 2 groups. Subgroup analysis was performed to determine if demographic information or tear size influenced operative time.

RESULTS

The average operative time in the SR group was 75.68 minutes and the average operative time in the TOE group was 89.24 minutes (P < .001). When controlling for all concomitant procedures, the operative time in the TOE group was 8.1 minutes longer than the SR group (P = .029). Average tear size in an anterior-posterior direction was larger in the TOE group vs. the SR group, 26.09 mm vs. 15.18 mm (P < .001).

CONCLUSION

When controlling for concomitant procedures, a knotless, TOE dual-row technique for aRCR adds an average of 8 minutes' operative time compared with a knotless SR technique. This was despite a significantly larger tear size in the TOE group.

摘要

背景

尽管关节镜下肩袖修复术(aRCR)已广泛应用,但对于双排与单排(SR)修复技术的优势仍存在较大争议。本研究比较了无结 SR 技术与经骨隧道等长双排(TOE)技术在 aRCR 中的手术时间,并确定了影响手术时间的患者特定因素。

方法

对 2014 年至 2018 年间由同一位外科医生行 aRCR 的 118 例采用无结 SR 技术的患者资料与 95 例行 aRCR 的采用 TOE 技术患者的资料进行比较。记录并比较两组患者的基线人口统计学资料和手术时间。行亚组分析以确定人口统计学资料或撕裂大小是否影响手术时间。

结果

SR 组的平均手术时间为 75.68 分钟,TOE 组的平均手术时间为 89.24 分钟(P<0.001)。在控制所有伴随手术的情况下,TOE 组的手术时间比 SR 组长 8.1 分钟(P=0.029)。TOE 组的前后方向撕裂大小平均比 SR 组大,分别为 26.09mm 和 15.18mm(P<0.001)。

结论

在控制伴随手术的情况下,与无结 SR 技术相比,无结、TOE 双排技术用于 aRCR 平均增加 8 分钟的手术时间。尽管 TOE 组的撕裂尺寸明显更大。

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