Endo Atsushi, Hoogervorst Paul, Safranek Conrad, Sochacki Kyle R, Safran Marc R, Sherman Seth L, Donahue Joseph
Sports Orthopedic and Rehabilitation, Redwood City, California, USA.
Stanford University, Bioengineering, Stanford, California, USA.
Orthop J Sports Med. 2020 Jul 16;8(7):2325967120938311. doi: 10.1177/2325967120938311. eCollection 2020 Jul.
Biomechanical studies have demonstrated that arthroscopic rotator cuff repair using a linked double-row equivalent construct results in significantly higher load to failure compared with conventional transosseous-equivalent constructs.
To determine the patient-reported outcomes (PROs), reoperation rates, and complication rates after linked double-row equivalent rotator cuff repair for full-thickness rotator cuff tears.
Case series; Level of evidence, 4.
Consecutive patients who underwent linked double-row equivalent arthroscopic rotator cuff repair with minimum 2-year follow-up were included. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) score at final follow-up. Secondary outcomes included the Simple Shoulder Test (SST), shortened Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, visual analog scale (VAS), reoperations, and complications. Clinical relevance was defined by the minimally clinically important difference (MCID). Comparisons on an individual level that exceeded MCID (individual-level scores) were deemed clinically relevant. Comparisons between preoperative and postoperative scores were completed using the Student test. All values were reported with significance set at < .05.
A total of 42 shoulders in 41 consecutive patients were included in this study (21 male patients [51.2%]; mean age, 64.5 ± 11.9 years; mean follow-up, 29.7 ± 4.5 months). All patients (100%) completed the minimum 2-year follow-up. The rotator cuff tear measured on average 15.2 ± 8.9 mm in the coronal plane and 14.6 ± 9.8 mm in the sagittal plane. The ASES score improved significantly from 35.5 ± 18.2 preoperatively to 93.4 ± 10.6 postoperatively ( < .001). The QuickDASH ( < .001), SST ( < .001), and VAS ( < .001) scores also significantly improved after surgery. All patients (42/42 shoulders; 100%) achieved clinically relevant improvement (met or exceeded MCID) on ASES and SST scores postoperatively. There were no postoperative complications (0.0%) or reoperations (0.0%) at final follow-up.
Arthroscopic repair of full-thickness rotator cuff tears with the linked double-row equivalent construct results in statistically significant and clinically relevant improvements in PRO scores with low complication rates (0.0%) and reoperation rates (0.0%) at short-term follow-up.
生物力学研究表明，与传统的经骨等效结构相比，使用连接双排等效结构进行关节镜下肩袖修复可显著提高至失败负荷。
确定采用连接双排等效结构修复全层肩袖撕裂后患者报告的结局（PROs）、再次手术率和并发症发生率。
病例系列；证据等级，4级。
纳入连续接受连接双排等效关节镜下肩袖修复且随访至少2年的患者。主要结局是末次随访时的美国肩肘外科医师（ASES）评分。次要结局包括简单肩部试验（SST）、简化版手臂、肩部和手部功能障碍问卷（QuickDASH）、视觉模拟量表（VAS）、再次手术情况和并发症。临床相关性由最小临床重要差异（MCID）定义。个体水平上超过MCID的比较（个体水平评分）被视为具有临床相关性。术前和术后评分的比较采用Student检验。所有P值报告时显著性设定为P < 0.05。
本研究共纳入41例连续患者的42个肩部（男性21例[51.2%]；平均年龄64.5±11.9岁；平均随访29.7±4.5个月）。所有患者（100%）完成了至少2年的随访。肩袖撕裂在冠状面平均为15.2±8.9mm，矢状面平均为14.6±9.8mm。ASES评分从术前的35.5±18.2显著提高至术后的93.4±10.6（P < 0.001）。术后QuickDASH（P < 0.001）、SST（P < 0.001）和VAS（P < 0.001）评分也显著改善。所有患者（42/42个肩部；100%）术后ASES和SST评分均实现了具有临床相关性的改善（达到或超过MCID）。末次随访时无术后并发症（0.0%）或再次手术（0.0%）。
采用连接双排等效结构进行关节镜下全层肩袖撕裂修复，在短期随访中可使PRO评分在统计学上有显著且具有临床相关性的改善，并发症发生率低（0.0%），再次手术率低（0.0%）。
