Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA; Pan Am Clinic, Winnipeg, MB, Canada.
Steadman Hawkins Clinic of the Carolinas, Greenville Health System, Greenville, SC, USA.
J Shoulder Elbow Surg. 2020 Jul;29(7S):S53-S58. doi: 10.1016/j.jse.2020.01.083. Epub 2020 Apr 10.
Multiple factors including muscle atrophy, fatty infiltration, smoking, advanced patient age, and increasing tear size have been identified as risk factors for retear after rotator cuff repair. However, little is known about what effect the length of the residual rotator cuff tendon has on the success of repair and patient outcomes.
This study included 64 patients. Patients were stratified based on a residual tendon length of greater than 15 mm (group 1, residual tendon) or 15 mm or less (group 2, no residual tendon). Rotator cuff tendon integrity was then evaluated using ultrasound imaging at 6 months. Outcome measures included the Single Assessment Numeric Evaluation score, visual analog scale score, EQ5D Index score, Global Rating of Change score, and Penn Shoulder Score.
No differences were found between groups regarding demographic data or repair configuration. Assessment of tendon healing demonstrated an increased rate of tendons that had "not healed" in group 2 (19.3% [n = 5] vs. 13.2% [n = 5]), but this difference was not statistically significant (P = .55). Functional outcome scores improved significantly from preoperatively to final follow-up in both groups and displayed no differences at 6-month follow-up.
A smaller residual tendon length was not a negative predictor of clinical outcomes following arthroscopic rotator cuff repair in patients with short-term follow-up. Although there was a trend toward a decreased rate of healing in patients with smaller residual tendons, this was not significant.
多种因素，包括肌肉萎缩、脂肪浸润、吸烟、患者年龄增长和撕裂口增大，已被确定为肩袖修复后再撕裂的危险因素。然而，对于肩袖残余肌腱的长度对修复成功和患者预后的影响，人们知之甚少。
本研究纳入了 64 名患者。根据残余肌腱长度大于 15mm（组 1，残余肌腱）或 15mm 或更短（组 2，无残余肌腱）对患者进行分层。然后使用超声成像在 6 个月时评估肩袖肌腱完整性。评估指标包括单一评估数字评估评分、视觉模拟评分、EQ5D 指数评分、总体变化评分和 Penn 肩评分。
两组在人口统计学数据或修复结构方面无差异。肌腱愈合评估显示，组 2 中“未愈合”的肌腱比例较高（19.3%[n=5]比 13.2%[n=5]），但差异无统计学意义（P=.55）。两组患者的功能预后评分均从术前显著改善到最终随访，6 个月随访时无差异。
在短期随访中，对于接受关节镜肩袖修复的患者，较小的残余肌腱长度并不是临床结果的负面预测因素。尽管较小残余肌腱患者的愈合率呈下降趋势，但无统计学意义。
