Fukushi Ryunosuke, Horigome Keiko, Yamashita Toshihiko
Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan.
Department of Orthopaedic Surgery, Asahikawa Kosei Hospital, Asahikawa, Japan.
JSES Int. 2020 Feb 13;4(2):352-356. doi: 10.1016/j.jseint.2019.12.002. eCollection 2020 Jun.
The diagnosis and treatment of partial-thickness rotator cuff tears remain controversial, and only a few studies have carried out clinical evaluation and comparison based on different types of tears. The aim of this study was to compare the clinical outcomes of arthroscopic cuff repairs using the suture bridge technique in patients with articular partial-thickness rotator cuff tears (APRCTs) vs. those with bursal partial-thickness rotator cuff tears (BPRCTs).
We retrospectively evaluated 29 patients with APRCTs and 22 patients with BPRCTs who underwent arthroscopic cuff repair using the suture bridge technique with a minimum 2-year follow-up. Clinical outcomes were evaluated preoperatively and postoperatively using the visual analog scale score, Japanese Orthopaedic Association (JOA) score, Constant score (CS), active range of motion (ROM) of shoulder flexion and abduction, improvement rate for each score, and retear rate.
The APRCT group had more women, fewer cases of subacromial decompression, and more patients whose condition changed intraoperatively and transitioned into a complete tear. Preoperatively, the JOA score, CS, ROM of shoulder flexion, ROM of shoulder abduction, and external shoulder rotation strength were lower in the APRCT group. Postoperatively, all scores improved significantly in both groups, and the JOA score, CS, and external shoulder rotation strength remained significantly lower in the APRCT group. Improvement and retear rates were not significantly different between the groups.
The suture bridge technique significantly improved the clinical outcomes of patients with APRCTs and BPRCTs. Preoperative and postoperative functional parameters were worse in APRCT patients.
部分厚度肩袖撕裂的诊断和治疗仍存在争议，仅有少数研究基于不同类型的撕裂进行了临床评估和比较。本研究的目的是比较采用缝线桥技术对关节侧部分厚度肩袖撕裂（APRCT）患者与滑囊侧部分厚度肩袖撕裂（BPRCT）患者进行关节镜下肩袖修复的临床结果。
我们回顾性评估了29例接受缝线桥技术关节镜下肩袖修复的APRCT患者和22例BPRCT患者，随访时间至少为2年。术前和术后使用视觉模拟量表评分、日本骨科协会（JOA）评分、Constant评分（CS）、肩部前屈和外展的主动活动范围（ROM）、各评分的改善率以及再撕裂率来评估临床结果。
APRCT组女性更多，肩峰下减压病例更少，术中病情变化并转变为完全撕裂的患者更多。术前，APRCT组的JOA评分、CS、肩部前屈ROM、肩部外展ROM和肩部外旋力量较低。术后，两组所有评分均显著改善，但APRCT组的JOA评分、CS和肩部外旋力量仍显著较低。两组之间的改善率和再撕裂率无显著差异。
缝线桥技术显著改善了APRCT和BPRCT患者的临床结果。APRCT患者术前和术后的功能参数较差。
