Elite Orthopedics and Sports Medicine, Nashville, Tennessee, U.S.A.
Ocean Orthopedics, Ventura, California, U.S.A.
Arthroscopy. 2021 Jan;37(1):28-37. doi: 10.1016/j.arthro.2020.08.003. Epub 2020 Aug 14.
The primary purpose of this study was to evaluate the repair integrity on magnetic resonance imaging (MRI), and secondarily, clinical outcomes, of medium to large (2-4 cm) rotator cuff tears treated using an arthroscopic triple-loaded medially based single-row repair technique augmented laterally with bone marrow vents.
This is a retrospective outcomes study of patients with full-thickness medium to large (2-4 cm) rotator cuff tears repaired by 4 surgeons at a single institution over a 2-year period with a minimum of 24 months' follow-up. A single-row repair with tension-minimizing medially based triple-loaded anchors and laterally placed bone marrow vents was used. Patients completed a satisfaction and pain survey, the Western Ontario Rotator Cuff index questionnaire, and a Short Form-36 version 2 survey to evaluate clinical outcomes. MRI was obtained at a minimum of 24 months follow-up to assess repair integrity.
A total of 64 males and 27 females with a mean age of 59.7 (range, 34-82) were included. The mean tear size was 2.6 cm in anteroposterior dimension, treated with a mean of 2.2 anchors. Eighty-three of 91 shoulders (91%) reported being completely satisfied with their result. The median Western Ontario Rotator Cuff score was 95.2% of normal, with a significant difference found between those with an intact repair and those with a full-thickness recurrent defect (median, 95.9% vs. 73.8%; P = .003). Postoperative MRI obtained at a median of 32 months (range, 24-48) demonstrated an intact repair in 84 of 91 shoulders (92%), with failure defined as a full-thickness defect of the tendon.
Arthroscopic repair of medium to large rotator cuff tears using triple-loaded medially based single-row repair augmented with marrow vents resulted in a 92% healing rate by MRI and excellent patient-reported outcomes LEVEL OF EVIDENCE: Level IV, retrospective case series.
本研究的主要目的是评估关节镜下三枚带线锚钉修复术联合外侧骨隧道骨髓挤压技术治疗中大型（2-4cm）肩袖全层撕裂的磁共振成像（MRI）修复完整性，次要目的是评估临床结果。
这是一项回顾性研究，纳入了 2 年内由 4 位医生在一家单机构治疗的全层中大型（2-4cm）肩袖撕裂患者，随访时间至少 24 个月。采用单排带线锚钉修复技术，三枚带线锚钉采用内上缘入路，以减轻张力，同时联合外侧骨隧道骨髓挤压技术。患者完成满意度和疼痛调查、Western Ontario Rotator Cuff 指数问卷和 Short Form-36 版本 2 调查，以评估临床结果。所有患者均在至少 24 个月的随访时进行 MRI 检查，以评估修复完整性。
共纳入 64 名男性和 27 名女性，平均年龄为 59.7 岁（范围，34-82 岁）。平均撕裂尺寸为 2.6cm 前后径，平均使用 2.2 枚锚钉。83 例（91%）肩完全满意。Western Ontario Rotator Cuff 评分中位数为正常的 95.2%，与修复完整和全层再撕裂的患者之间存在显著差异（中位数，95.9%比 73.8%；P=0.003）。术后 MRI 检查在平均 32 个月（范围，24-48 个月）获得，91 例中有 84 例（92%）显示修复完整，定义为肌腱全层缺损为失败。
关节镜下三枚带线锚钉修复术联合外侧骨隧道骨髓挤压技术治疗中大型肩袖全层撕裂的修复率为 92%，MRI 检查显示愈合良好，患者报告的结果优良。
IV 级，回顾性病例系列。
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