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Subcoracoid 囊肿的形成是否可能是肩袖前上撕裂和二头肌滑车病变的征象?一项前瞻性放射学和关节镜相关性研究。

Can subcoracoid cyst formation be a sign of anterosuperior rotator cuff tears and biceps pulley lesions? A prospective radiologic and arthroscopic correlation study.

机构信息

Department of Orthopaedics and Traumatology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.

Department of Orthopaedics and Traumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

出版信息

J Shoulder Elbow Surg. 2020 Aug;29(8):1665-1670. doi: 10.1016/j.jse.2019.11.036. Epub 2020 Mar 16.

DOI:10.1016/j.jse.2019.11.036
PMID:32192879
Abstract

BACKGROUND

The aim of this study was to investigate the pathologies associated with subcoracoid cysts (ScCs) in patients with rotator cuff (RC) tears and the postoperative appearance of ScCs after arthroscopic repair.

METHODS

A total of 114 patients who underwent arthroscopic RC repair were prospectively evaluated. The inclusion criteria were as follows: patients with or without ScCs, patients with Patte class 1 or 2 tears, and patients who were 40-65 years of age. Forty-four patients with ScCs (group 1) were evaluated during the 12-month study period. Fifty-two patients who had no ScCs (group 2) were evaluated as a control group. Preoperative and postoperative cyst volumes were measured on magnetic resonance imaging (MRI), and arthroscopic findings were noted.

RESULTS

Thirty-one patients (70%) in group 1 had a subscapularis tear vs. 10 patients (19%) in group 2 (P < .001). Biceps lesions were encountered in 32 patients (72%) in group 1, whereas 12 patients (23%) had a biceps lesion in group 2 (P < .001). Cyst volume was significantly higher in the following situations: (1) patients who had a subscapularis tear compared with patients without a subscapularis tear, (2) patients who had biceps pulley lesions compared with patients without pulley lesions, and (3) patients who had both pathologies (P = .047, P = .01, and P = .002, respectively). Cyst volumes significantly decreased following RC repair in group 1 (P < .001).

CONCLUSION

Among patients with small- to medium-sized, full-thickness supraspinatus tears, the prevalence of biceps pulley lesions and/or subscapularis tears is higher in patients with ScCs.

摘要

背景

本研究旨在探讨肩袖撕裂患者肩峰下囊肿(ScC)的相关病理以及关节镜修复后 ScC 的术后表现。

方法

前瞻性评估了 114 例行关节镜肩袖修复的患者。纳入标准为:有无 ScC、Patte 1 或 2 型撕裂、40-65 岁的患者。在 12 个月的研究期间,评估了 44 例有 ScC(组 1)的患者。52 例无 ScC(组 2)的患者作为对照组进行评估。术前和术后通过磁共振成像(MRI)测量囊肿体积,并记录关节镜检查结果。

结果

组 1 中有 31 例(70%)患者肩胛下肌撕裂,而组 2 中有 10 例(19%)(P<.001)。组 1 中有 32 例(72%)患者肱二头肌病变,而组 2 中有 12 例(23%)患者肱二头肌病变(P<.001)。在以下情况下,囊肿体积显著更高:(1)有肩胛下肌撕裂的患者比没有肩胛下肌撕裂的患者,(2)有肱二头肌滑囊病变的患者比没有滑囊病变的患者,以及(3)有这两种病变的患者(P=.047、P=.01 和 P=.002)。组 1 中 RC 修复后囊肿体积显著减小(P<.001)。

结论

在患有小至中等大小、全层冈上肌撕裂的患者中,ScC 患者中肱二头肌滑囊病变和/或肩胛下肌撕裂的患病率更高。

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