Jain Siddharth, Garg Sitender, Mittal Ravi, Digge Vijay Kumar, Shukla Ashish, V Ganesh
Orthopedics, All India Institute of Medical Sciences, New Delhi, IND.
Orthopedics, Indian Army, New Delhi, IND.
Cureus. 2020 Jan 17;12(1):e6690. doi: 10.7759/cureus.6690.
Introduction Repair of a "U" shaped rotator cuff tear tends to create extreme tensile forces at the central part of the rotator cuff margin, causing tensile overload and may result in subsequent failure. We describe our technique of repairing the "U" shaped tear in which margin convergence is done using Ethibond (Ethicon Inc., New Jersey) and a single triple-loaded suture anchor. It results in the reduction of the strain and also allows the repair of seemingly irreparable tears. Patients and method We included 10 patients having a "U" shaped degenerative rotator cuff tear. All patients were assessed preoperatively. The University of California at Los Angeles Shoulder score (UCLA shoulder score) recorded preoperatively and at final follow-up was used to assess functional outcome. Result Out of 10 patients, six were males and four were females. The mean age was 60 years (range 50-70 years). The average follow-up was for 31 months (range 24 - 48 months). The UCLA score increased from an average of 9 preoperatively (range 8 - 12) to an average of 29.6 (range 27 - 31) at the terminal follow-up. The UCLA increased in the postoperative period and was statistically significant (unpaired t-test; p < 0.0001). All patients had good/excellent outcomes (UCLA score > 27). Abduction increased from average 27 degree preoperatively (range 20 degree - 35 degree) to an average 131 degree (range 125 degree - 140 degree) at final follow-up (unpaired t-test; p < 0.0001). Conclusion Our technique of modified margin convergence achieves low tension repair and anatomical footprint reconstruction with good clinical outcomes using a single triple-loaded anchor.
引言 “U”形肩袖撕裂的修复往往会在肩袖边缘的中央部分产生极大的拉力，导致拉伸过载，并可能导致随后的修复失败。我们描述了一种修复“U”形撕裂的技术，其中使用Ethibond（Ethicon公司，新泽西州）和单个三重负载缝线锚钉进行边缘对合。这会减少应变，还能修复看似无法修复的撕裂。
患者与方法 我们纳入了10例患有“U”形退行性肩袖撕裂的患者。所有患者均在术前进行了评估。术前和最终随访时记录的加州大学洛杉矶分校肩关节评分（UCLA肩关节评分）用于评估功能结果。
结果 10例患者中，男性6例，女性4例。平均年龄为60岁（范围50 - 70岁）。平均随访时间为31个月（范围24 - 48个月）。UCLA评分从术前平均9分（范围8 - 12分）增加到最终随访时的平均29.6分（范围27 - 31分）。术后UCLA评分增加，且具有统计学意义（非配对t检验；p < 0.0001）。所有患者均获得良好/优秀的结果（UCLA评分> 27）。外展角度从术前平均27度（范围20度 - 35度）增加到最终随访时的平均131度（范围125度 - 140度）（非配对t检验；p < 0.0001）。
结论 我们改良的边缘对合技术使用单个三重负载锚钉实现了低张力修复和解剖足迹重建，临床效果良好。
