Orthopädische Klinik Luzern AG, Lucerne, Switzerland.
Department of Orthopaedics and Trauma Surgery, Alfried Krupp Hospital, Alfried-Krupp-Straße 21, 45131, Essen, Germany.
Arch Orthop Trauma Surg. 2022 Jan;142(1):25-31. doi: 10.1007/s00402-020-03584-3. Epub 2020 Aug 25.
To date two main techniques are used in arthroscopic full-thickness rotator cuff tears, the conventional knot-tying suture bridge technique and the knotless technique. We evaluated whether there is a difference in clinical outcome using both techniques. Our patients underwent arthroscopic treatment of full-thickness rotator cuff tears, and we retrospectively evaluated clinical function, strength and surgery time. Eighty-three shoulders operated between September 2012 and December 2013 were included in the study. We had nineteen patients in the knotless group, and sixty-four in the knot-tying group. In addition, we performed preoperatively radiological (magnetic resonance imaging-MRI) conformation of full-thickness rotator cuff tear in our patients. For clinical evaluation, we used Quick Disabilities of the Arm, Shoulder and Hand score (q-DASH) and the Shoulder Pain and Disability (SPADI) score, and we measured the strength of a range of motion postoperatively using a conventional dynamometer. The patients were evaluated preoperatively, and at 6, 9, and 12 months postoperatively. The follow-up period was 12 months. The scores in both treatment groups improved at twelve months follow-up, but there was no statistical difference between both groups at twelve months after surgery; q-DASH score between groups (p = 0.092) and SPADI score (p = 0.700). Similarly, there was no statistical difference between the groups in regard to strength, surgery time, and range of motion at the twelve months follow-up. Our data confirm that both techniques may be used successfully to repair full-thickness rotator cuff tears with very good functional outcome.Level of evidence IV.
迄今为止,关节镜下治疗全层肩袖撕裂主要有两种技术,即传统的打结缝线桥接技术和无结技术。我们评估了这两种技术的临床效果是否存在差异。我们的患者均接受了关节镜下全层肩袖撕裂修复治疗,回顾性评估了临床功能、力量和手术时间。本研究纳入了 2012 年 9 月至 2013 年 12 月期间接受手术的 83 例患者。无结组 19 例,打结组 64 例。此外,我们对所有患者术前进行了全层肩袖撕裂的影像学(磁共振成像-MRI)确认。临床评估采用简易上肢功能测试(Quick Disabilities of the Arm, Shoulder and Hand score,q-DASH)和肩痛及残疾指数(Shoulder Pain and Disability,SPADI)评分,术后使用常规测力计测量关节活动度的力量。患者在术前、术后 6、9 和 12 个月接受评估,随访时间为 12 个月。两组患者在 12 个月随访时评分均有所改善,但术后 12 个月时两组间无统计学差异;q-DASH 评分(p=0.092)和 SPADI 评分(p=0.700)。同样,两组在 12 个月随访时的力量、手术时间和关节活动度也无统计学差异。我们的数据证实,两种技术均可成功用于修复全层肩袖撕裂,且功能恢复效果非常好。证据等级 IV。