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术后超声对肩袖肌腱修复后锚钉拔出的早期检测的作用:3 例报告。

Contribution of postoperative ultrasound to early detection of anchor pullout after rotator cuff tendon repair: Report of 3 cases.

机构信息

Polyclinique de l'Ormeau, 28, boulevard du 8-mai-1945, 65000 Tarbes, France.

CHU de Toulouse, place Baylac, 31059 Toulouse cedex 09, France.

出版信息

Orthop Traumatol Surg Res. 2020 Apr;106(2):229-234. doi: 10.1016/j.otsr.2019.12.012. Epub 2020 Mar 17.

Abstract

INTRODUCTION

Rotator cuff repair by suture bridge is now widely used. Few studies reported secondary pullout of radiotransparent anchors. The aim of the present prospective study was to demonstrate the contribution of in-office ultrasonography to detect pullout, and to describe the examination procedure.

MATERIAL AND METHOD

A total of 102 patients underwent arthroscopic rotator cuff repair by suture bridge, with impacted second-row anchors. Ultrasonography was performed by the surgeon in postoperative consultations.

RESULTS

At 6 weeks' follow-up, 3 patients showed mean 2nd-row implant pullout of 8.3mm. All underwent arthroscopic revision to extract the implant, which was mobile within its tunnel in all cases. Clinical progression was good, with mean Constant score 72 and no aggravation of the lesion on ultrasound at 3 months' follow-up.

DISCUSSION

The present series would seem to be the first to report: early radiotransparent in-vivo pullout 6 weeks after suture bridge cuff repair; ultrasound detection of pullout in consultation by the orthopedic surgeon; a description of the ultrasound technique for screening this rare and specific problem.

CONCLUSION

Ultrasound now enables radiotransparent anchor positioning to be monitored following rotator cuff repair as of the first postoperative days, without compromising tendon healing.

LEVEL OF EVIDENCE

II.

摘要

简介

缝合桥技术修复肩袖现在已经得到广泛应用。但很少有研究报道过透明线锚钉的二次拔出。本前瞻性研究旨在证明在诊室中使用超声检查来检测肩袖修复术后的透明线锚钉拔出的作用,并描述相关的检查过程。

材料和方法

共有 102 例患者接受了关节镜下缝合桥技术修复肩袖损伤,并用可吸收缝线进行了第二排锚钉固定。术后由外科医生进行超声检查。

结果

在 6 周的随访中,3 名患者出现第二排植入物平均 8.3mm 的拔出。所有患者均接受了关节镜下翻修手术,以取出可移动的植入物。所有患者的临床进展良好,Constant 评分平均为 72 分,在 3 个月的随访时,超声检查未发现病变加重。

讨论

本研究系列似乎是第一个报道:缝合桥肩袖修复术后 6 周时出现透明线的早期体内拔出;超声检查可在门诊由骨科医生检测到拔出;描述了筛查这种罕见和特殊问题的超声技术。

结论

超声检查现在可以在肩袖修复术后的最初几天监测透明线锚钉的位置,而不会影响肌腱愈合。

证据等级

II 级。

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