Department of Orthopaedics and Trauma Surgery, Niels-Stensen-Kliniken, Franziskus Hospital-Harderberg, Alte Rothenfelderstr. 11, 49124, Georgsmarienhütte, Germany.
OrthoMainfranken, Würzburg, Germany.
Musculoskelet Surg. 2022 Mar;106(1):9-14. doi: 10.1007/s12306-020-00664-w. Epub 2020 May 21.
Structural failures after rotator cuff repair are well known, and despite advances and improved techniques in rotator cuff repair (RCR), retear rates remain high. The aim of this study was to (1) evaluate the midterm clinical and radiological outcomes after revision RCR and to (2) analyze whether preoperative ultrasound can predict outcome of open revision rotator cuff repair.
Twenty-five patients who underwent revision RCR in a single institution between 2010 and 2012 were retrospectively reviewed at a minimum follow-up of 2 years. The Constant Score (CS) and the Disabilities of the Arm, Shoulder and Hand score were collected. Ultrasound examination was used both before revision surgery and at follow-up to determine tendon integrity.
At the final follow-up, 69.6% patients showed an intact rotator cuff and their CS had improved from 28.3 to 77. 30.4% patients had a persisting rotator cuff defect, and the CS had improved from 24 to 47.7. A preoperative tear size of more than 20 mm from an ultrasound examination could be identified as a factor that would risk structural failure of revision RCR.
(1) Clinical outcomes after revision RCR improve in both patients with an intact RC and those with a retear at midterm follow-up. (2) Ultrasound seems to be a useful tool to predict whether reconstruction of recurrent rotator cuff tears is feasible.
IV, Case series.
肩袖修复术后的结构失败是众所周知的，尽管肩袖修复术（RCR）有了进步和技术改进，再撕裂率仍然很高。本研究的目的是：（1）评估翻修 RCR 后的中期临床和影像学结果；（2）分析术前超声是否能预测开放式翻修肩袖修复的结果。
回顾性分析 2010 年至 2012 年间在一家机构接受翻修 RCR 的 25 例患者，随访时间至少为 2 年。收集了 Constant 评分（CS）和上肢残疾问卷（DASH）评分。在翻修手术前和随访时均进行超声检查，以确定肌腱的完整性。
在最终随访时，69.6%的患者肩袖完整，CS 从 28.3 提高到 77.3。40.4%的患者肩袖持续存在缺陷，CS 从 24 提高到 47.7。术前超声检查发现撕裂大于 20mm 可作为翻修 RCR 结构失败的风险因素。
（1）翻修 RCR 后，无论肩袖完整的患者还是再撕裂的患者，中期临床结果都有所改善。（2）超声似乎是一种预测复发性肩袖撕裂重建是否可行的有用工具。
IV，病例系列。
