Memon Kashif A, Dimock Richard A C, Cobb Timothy, Consigliere Paolo, Imam Mohamed A, Narvani A Ali
Rowley Bristow Unit, Ashford and St Peter's NHS Trust, Chertsey, United Kingdom.
Fortius Clinic, London, United Kingdom.
Arthrosc Tech. 2020 Jun 27;9(7):e987-e993. doi: 10.1016/j.eats.2020.03.022. eCollection 2020 Jul.
Despite profound advancements in arthroscopic rotator cuff repair (RCR) techniques, radiologic failure rates may be in excess of 60% with repairs of large and massive tears in the elderly population. One of the strategies to improve these healing rates has been "patch" augmentation of the cuff repair. At the same time, superior capsular reconstruction (SCR) has gained significant popularity as an option for irreparable rotator cuff (RC) tears. Some have also advocated performing SCR in addition to arthroscopic RCR to reinforce the repair and improve healing rates. Techniques involving the use of fascia lata, ECM patches, and long head of the biceps (LHB) for SCR to reinforce the cuff repair have all been elegantly described. In this article, we propose a technique that enables a combination of the aforementioned procedures and involves performing RCR with patch augmentation, as well as SCR using LHB. In doing so, the repaired RC is bordered by the patch over its bursal surface and the LHB on the articular surface (functioning as the superior capsule), thus giving us the name "Hamburger technique" (a 3-layered construct).
尽管关节镜下肩袖修补术（RCR）技术取得了巨大进展，但在老年人群中，对于大型和巨大肩袖撕裂的修复，影像学上的失败率可能超过60%。提高这些愈合率的策略之一是对肩袖修补进行“补片”增强。与此同时，作为不可修复肩袖（RC）撕裂的一种选择，上盂唇重建术（SCR）已广受欢迎。一些人还主张在关节镜下RCR之外进行SCR，以加强修复并提高愈合率。涉及使用阔筋膜、细胞外基质补片和肱二头肌长头（LHB）进行SCR以加强肩袖修补的技术均已得到详尽描述。在本文中，我们提出一种技术，该技术能够将上述手术相结合，包括进行带补片增强的RCR以及使用LHB进行SCR。这样一来，修复后的肩袖在其滑囊面由补片界定，在关节面由LHB界定（起到上盂唇的作用），因此我们将其命名为“汉堡技术”（一种三层结构）。
