Kim Jeong Woo, Nam Dae Jin
Department of Orthopedic Surgery, Wonkwang University Hospital, Iksan, Korea.
Arthrosc Tech. 2020 Jan 24;9(2):e275-e281. doi: 10.1016/j.eats.2019.10.007. eCollection 2020 Feb.
The treatment of massive and irreparable rotator cuff tears remains a challenge for shoulder surgeons. When treating patients with chronic rotator cuff tears, especially those with severe fatty degeneration, severe tendon retraction, or muscle atrophy, the risk of re-tear and persistent severe pain persists. Therefore, surgeons can choose from numerous options. Superior capsular reconstruction (SCR) was introduced as a technique to maintain the stability of the upper shoulder and stabilize the muscles without repairing the supraspinatus and infraspinatus. Various autograft and allograft techniques have been developed. SCR performed using an autograft has the disadvantage of requiring harvesting the tensor fascia lata. Although allografts reduce harvest time, they also increase donor-site morbidity and the time required for healing. To solve the healing problem, we have introduced an SCR technique through grafting with the Achilles tendon-bone. Although this is an unproven technique for patients with chronic irreparable rotator cuff tears, our short-term outcomes seem promising. Further studies and follow-ups are needed to determine the success of this technique.
对于肩部外科医生而言，治疗巨大且无法修复的肩袖撕裂仍然是一项挑战。在治疗慢性肩袖撕裂患者时，尤其是那些伴有严重脂肪变性、严重肌腱回缩或肌肉萎缩的患者，再次撕裂和持续剧痛的风险依然存在。因此，外科医生有多种选择。上盂唇重建术（SCR）作为一种维持肩关节上部稳定性并稳定肌肉而无需修复冈上肌和冈下肌的技术被引入。已经开发出了各种自体移植和异体移植技术。使用自体移植进行SCR的缺点是需要切取阔筋膜张肌。尽管异体移植减少了切取时间，但它们也增加了供区并发症以及愈合所需时间。为了解决愈合问题，我们通过跟腱-骨移植引入了一种SCR技术。尽管对于慢性不可修复的肩袖撕裂患者来说，这是一种未经证实的技术，但我们的短期结果似乎很有前景。需要进一步的研究和随访来确定该技术的成功率。
