Roth Travis S, Welsh Matthew L, Osbahr Daryl C, Varma Amit
American Sports Medicine Institute, Birmingham, Alabama, U.S.A.
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, U.S.A.
Arthrosc Tech. 2020 Apr 25;9(5):e675-e681. doi: 10.1016/j.eats.2020.01.024. eCollection 2020 May.
Massive, irreparable rotator cuff tears are challenging to manage. Often, these tears are not amenable to primary repair and necessitate additional treatment options. This is especially true in patients with absent glenohumeral arthritis in the setting of a massive, irreparable rotator cuff tear. Superior capsular reconstruction (SCR), originally described by Mihata using a fascia lata autograft, has grown in popularity for the treatment of irreparable rotator cuff tears as a salvage option with good clinical outcomes. More recently, SCR techniques have been described using dermal allograft. Biomechanical studies and reported clinical series show promising results, with favorable postoperative clinical outcomes. The procedure, however, may be technically challenging, especially when performed using an all-arthroscopic technique. This article describes an all-arthroscopic technique using a predetermined graft size, unique medial fixation to ease graft passage, and knotless single-row lateral fixation to optimize suture management and efficiency.
巨大的、无法修复的肩袖撕裂的治疗颇具挑战性。通常，这些撕裂无法进行一期修复，需要其他治疗选择。在巨大的、无法修复的肩袖撕裂且无盂肱关节炎的患者中尤其如此。上盂唇重建术（SCR）最初由Mihata描述，使用自体阔筋膜移植，作为一种挽救性选择，用于治疗无法修复的肩袖撕裂，临床效果良好，近年来越来越受欢迎。最近，也有使用同种异体真皮进行SCR技术的描述。生物力学研究和报道的临床系列显示了有前景的结果，术后临床效果良好。然而，该手术在技术上可能具有挑战性，尤其是采用全关节镜技术时。本文描述了一种全关节镜技术，该技术使用预先确定的移植物尺寸、独特的内侧固定以方便移植物通过，以及无结单排外侧固定以优化缝线管理和效率。
