Inui Hiroaki, Sashi Ryuzi, Nobuhara Katsuya
Department of Orthopaedic Surgery, Nobuhara Hospital and Institute of Biomechanics, Tatsunoshi, Hyogo, Japan.
Department of Radiology, Yaesu Clinic, Nihonbashi, Chuoku, Tokyo, Japan.
JSES Int. 2020 Jul 22;4(4):900-905. doi: 10.1016/j.jseint.2020.06.007. eCollection 2020 Dec.
The pathogenesis of articular- and bursal-sided partial-thickness rotator cuff tears (PTRCTs) is considered to be different, and associated lesions with PTRCTs need to be examined.
The current study consisted of 76 shoulders of 73 patients (27 men, 46 women, 64.0 ± 8.3 years old) who underwent mini-open repair after conversion to full-thickness tears for either articular side (group A; n = 56) or bursal side (group B; n = 20) PTRCT with at least a 2-year follow-up. Clinical outcomes and their images were compared between the groups. Plain radiographs were used with the arm passively elevated in maximum elevation to assess restriction of glenohumeral motion.
The retear rate was not significantly different between the groups. Both groups showed significant improvement in functional scores at the final follow-up. Patients in group A showed a higher incidence of preoperative fibrosis in the rotator interval (69.6% vs. 35.0%, respectively; = .006) and a lower incidence of an acromial spur (7.1% vs. 35.0%, respectively; = .008) compared with group B. Plain radiographs with arm elevation showed restriction of glenohumeral movement in 49 of 76 shoulders (64.5%) preoperatively, including 36 of the 46 shoulders with fibrosis and 13 of the other 30 shoulders.
Both articular- and bursal-sided PTRCTs showed significant functional improvements after surgery. The articular-sided tears had a lower incidence of an acromial spur, but had a higher incidence of fibrosis in the rotator interval, which led to a limitation in glenohumeral motion.
关节侧和滑囊侧部分厚度肩袖撕裂（PTRCTs）的发病机制被认为有所不同，且需要对与PTRCTs相关的病变进行检查。
本研究纳入了73例患者的76个肩部（男性27例，女性46例，年龄64.0±8.3岁），这些患者因关节侧（A组；n = 56）或滑囊侧（B组；n = 20）PTRCT转变为全层撕裂后接受了小切口修复，并至少随访了2年。对两组的临床结果及其影像进行了比较。使用普通X线片，在手臂被动抬高至最大高度时评估盂肱关节活动受限情况。
两组间再撕裂率无显著差异。两组在末次随访时功能评分均有显著改善。与B组相比，A组患者术前在旋转间隙出现纤维化的发生率更高（分别为69.6%和35.0%；P = 0.006），肩峰骨赘的发生率更低（分别为7.1%和35.0%；P = 0.008）。手臂抬高时的普通X线片显示，术前76个肩部中有49个（64.5%）存在盂肱关节活动受限，其中46个有纤维化的肩部中有36个，另外30个肩部中有13个。
关节侧和滑囊侧PTRCTs术后功能均有显著改善。关节侧撕裂肩峰骨赘的发生率较低，但旋转间隙纤维化的发生率较高，这导致了盂肱关节活动受限。
