Kanatlı Ulunay, Ayanoğlu Tacettin, Ataoğlu Muhammet Baybars, Özer Mustafa, Çetinkaya Mehmet, Eren Toygun Kağan
Department of Orthopedics and Traumatology, Gazi University, School of Medicine, Ankara, Turkey.
Department of Orthopaedics and Traumatology, Abant İzzet Baysal University, School of Medicine, Bolu, Turkey.
Acta Orthop Traumatol Turc. 2020 Mar;54(2):196-201. doi: 10.5152/j.aott.2020.02.486.
Patients who underwent arthroscopic repair for partial rotator cuff tears were evaluated retrospectively. This study purposed to assess the postoperative clinical results of arthroscopic treatment of intratendinous rotator cuff tears and to investigate the effect of the tear type on the postoperative clinical outcomes.
Overall, 60 patients [36 women and 24 men; mean age: 48.6±12.2 years (range 33-67 years)] who underwent arthroscopic repair of Ellman stage 3 partial rotator cuff tear were evaluated retrospectively. These patients were grouped into the following three groups: articular-sided tears, bursal-sided tears, and intratendinous tears, with 20 patients included in each group. Subacromial decompression, acromioplasty, and tear repair without transforming to full-thickness tear were applied to the bursal-sided tears. The same technique was performed for intratendinous ruptures, with the only technical difference was that the capsular tissue was preserved during debridement of intratendinous tears. The articular-sided tears were transformed to complete tears and repaired arthroscopically. The preoperative and postoperative ASES scores and range of motion improvements were evaluated in all patients. The mean follow-up time was 44±6.5 months (range: 36-62 months).
No significant intergroup differences were observed concerning the age and the mean follow-up duration (p=0.524, p=0.665). A similar increase in ASES scores was observed for all three types of tears (bursal-sided tears: 31.09-82.65; articular-sided tears: 35.50--84.00; intratendinous tears: 34.01-83.49). Statistically, no significant intergroup difference was observed concerning ASES score improvement (p=0.585). An increase in mean forward flexion, abduction, and external rotation were observed, especially, a statistically significant increase in flexion (p=0.001) and abduction (p=0.001) in all three types of tears. No patient experienced any intraoperative or postoperative complications.
The results of arthroscopic treatment of intratendinous tears were similar to the other types of partial tears, and the results of arthroscopic treatment of grade 3 partial rotator cuff tears revealed satisfactory outcomes, regardless of the type of the tear.
Level III, Therapeutic study.
对接受关节镜下部分肩袖撕裂修复术的患者进行回顾性评估。本研究旨在评估关节镜治疗肌腱内肩袖撕裂的术后临床结果，并探讨撕裂类型对术后临床结局的影响。
本研究对60例接受Ellman 3期部分肩袖撕裂关节镜修复术的患者[36例女性和24例男性；平均年龄：48.6±12.2岁（范围33 - 67岁）]进行回顾性评估。这些患者被分为以下三组：关节侧撕裂组、滑囊侧撕裂组和肌腱内撕裂组，每组20例。对滑囊侧撕裂采用肩峰下减压、肩峰成形术以及不转变为全层撕裂的撕裂修复术。肌腱内撕裂采用相同技术，唯一的技术差异是在肌腱内撕裂清创时保留关节囊组织。关节侧撕裂转变为完全撕裂并进行关节镜修复。评估所有患者术前和术后的ASES评分及活动度改善情况。平均随访时间为44±6.5个月（范围：36 - 62个月）。
在年龄和平均随访时间方面，未观察到显著的组间差异（p = 0.524，p = 0.665）。三种类型的撕裂（滑囊侧撕裂：31.09 - 82.65；关节侧撕裂：35.50 - 84.00；肌腱内撕裂：34.01 - 83.49）的ASES评分均有类似增加。统计学上，在ASES评分改善方面未观察到显著的组间差异（p = 0.585）。观察到平均前屈、外展和外旋增加，特别是在所有三种类型的撕裂中，前屈（p = 0.001）和外展（p = 0.001）有统计学显著增加。没有患者经历任何术中或术后并发症。
肌腱内撕裂的关节镜治疗结果与其他类型的部分撕裂相似，无论撕裂类型如何，3级部分肩袖撕裂的关节镜治疗结果均显示出满意的效果。
III级，治疗性研究。
