Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao, China; Traumatic Orthopedic Institute of Shandong Province, Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Sports Medicine, Affiliated Hospital of Qingdao University, Qingdao, China.
J Shoulder Elbow Surg. 2020 Oct;29(10):2072-2079. doi: 10.1016/j.jse.2020.03.006. Epub 2020 Jun 1.
We aimed to report the clinical outcomes of arthroscopic débridement vs. repair for Ellman grade II bursal-side partial-thickness rotator cuff tears.
Patients who presented with Ellman grade II bursal-side partial-thickness rotator cuff tears from September 2015 to August 2017 were included. On the basis of preoperative findings and patient preference, 20 patients underwent débridement whereas 26 underwent arthroscopic repair. The visual analog scale (VAS), Constant-Murley shoulder, American Shoulder and Elbow Surgeons, and University of California-Los Angeles scores were assessed. Magnetic resonance imaging and B-mode ultrasonography were performed preoperatively and at 6, 12, and 24 months postoperatively.
All 46 patients were available throughout follow-up. At 2 years postoperatively, the VAS score had improved from 6.42 ± 1.56 to 0.65 ± 0.51 in the débridement group and from 6.26 ± 1.32 to 0.75 ± 0.42 in the repair group. The VAS score differed significantly between the 2 groups at 6 months postoperatively. All patient-reported outcomes improved in both groups. The American Shoulder and Elbow Surgeons score (P = .009), Constant-Murley shoulder score (P = .014), and University of California-Los Angeles score (P = .030) differed significantly between the 2 groups (higher in the débridement group) at 6 months postoperatively. Finally, 44 patients having intact tendon repairs with no interval worsening of partial-thickness tears underwent postoperative scheduled magnetic resonance imaging and B-mode ultrasonography examinations.
Arthroscopic débridement and repair of Ellman grade II bursal-side partial-thickness rotator cuff tears achieved comparable clinical scores and low retear rates during 2 years of follow-up. However, débridement achieved better results, especially within 6 months postoperatively, and achieved a favorable prognosis up to 2 years postoperatively.
我们旨在报告关节镜下清创术与修复术治疗 Ellman Ⅱ级囊侧部分厚度肩袖撕裂的临床结果。
纳入 2015 年 9 月至 2017 年 8 月间就诊的 Ellman Ⅱ级囊侧部分厚度肩袖撕裂患者。根据术前发现和患者偏好，20 例患者行清创术，26 例行关节镜下修复术。采用视觉模拟评分（VAS）、Constant-Murley 肩关节、美国肩肘外科医师协会（American Shoulder and Elbow Surgeons，ASES）和加利福尼亚大学洛杉矶分校（University of California-Los Angeles，UCLA）评分进行评估。所有患者术前及术后 6、12、24 个月行磁共振成像（magnetic resonance imaging，MRI）和 B 型超声检查。
46 例患者均获得随访。术后 2 年，清创组 VAS 评分由术前 6.42 ± 1.56 分改善至 0.65 ± 0.51 分，修复组由术前 6.26 ± 1.32 分改善至 0.75 ± 0.42 分，术后 6 个月两组间 VAS 评分差异有统计学意义。两组患者的所有患者报告结局均改善。术后 6 个月，ASES 评分（P =.009）、Constant-Murley 肩关节评分（P =.014）和 UCLA 评分（P =.030）差异有统计学意义（清创组更高）。最后，44 例肌腱修复完整且部分厚度撕裂无间隔恶化的患者接受了术后计划的 MRI 和 B 型超声检查。
关节镜下清创术与修复术治疗 Ellman Ⅱ级囊侧部分厚度肩袖撕裂，在 2 年随访中获得了相当的临床评分和较低的再撕裂率。然而，清创术在术后 6 个月内获得了更好的结果，并且在术后 2 年内获得了有利的预后。
