Charité-Universitaetsmedizin Berlin.
Vail, Colorado.
Arthroscopy. 2020 Feb;36(2):381-382. doi: 10.1016/j.arthro.2019.11.103.
Irreparable rotator cuff tears are challenging to treat, especially in highly active and young patients. Superior capsule reconstruction is a joint-preserving, anatomic, and arthroscopic option that has shown promising mid-term results. Over time, this procedure has undergone evolution in terms of patient selection and technical aspects, such as graft choices and fixation methods. Initially, superior capsule reconstruction was used for isolated irreparable tears of the supraspinatus tendon; now, the indication has widened to technically irreparable massive posterosuperior rotator cuff tears. The trend in North America and Europe has been toward using human dermal allografts, as opposed to fascia lata autografts, to avoid donor-site morbidity and reduce surgery time. How these modifications affect clinical outcomes and whether dermal allografts heal remains unknown.
不可修复的肩袖撕裂是具有挑战性的治疗,特别是在高度活跃和年轻的患者。上囊重建是一种保留关节、解剖和关节镜的选择,已经显示出有前途的中期结果。随着时间的推移,该手术在患者选择和技术方面(如移植物选择和固定方法)经历了演变。最初,上囊重建用于治疗孤立性不可修复的冈上肌腱撕裂;现在,适应证已扩大到技术上不可修复的巨大肩袖后上侧撕裂。北美的趋势是使用异体真皮移植物,而不是阔筋膜自体移植物,以避免供体部位发病率并减少手术时间欧洲。这些修改如何影响临床结果以及真皮移植物是否愈合尚不清楚。