Malavolta Eduardo Angeli, Andrade-Silva Fernando Brandão, Canhos André Lange, Assunção Jorge Henrique, Gracitelli Mauro Emilio Conforto, Ferreira Neto Arnaldo Amado
Shoulder and Elbow Group, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil.
Rev Bras Ortop (Sao Paulo). 2020 Dec;55(6):742-747. doi: 10.1055/s-0039-1698803. Epub 2019 Dec 19.
To evaluate the influence of the supraspinal tear pattern on the pre- and postoperative functional evaluations. A retrospective cohort study comparing patients with supraspinatus crescent-shaped tears versus L- or U-shaped tears. We included patients undergoing complete supraspinatus arthroscopic repair. We did not include patients with subscapularis or infraspinatus repair, those submitted to open surgery, or those in whom only partial repair was achieved. The clinical scales used were the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment (ASES) and the Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA), which were applied 1 week before and 24 months after the procedure. We analyzed 167 shoulders (from 163 patients). In the preoperative period, the ASES scale was significantly higher in the crescent-shaped pattern (43.5 ± 17.6 versus 37.7 ± 13.8; = 0.034). The UCLA scale followed the same pattern (15.2 ± 4.6 versus 13.5 ± 3.6; = 0.028). In the postoperative period, however, there was no significant difference. According to the ASES scale, crescent-shaped tears scored 83.7 ± 18.7 points, and L- or U-shaped tears scored 82.9 ± 20.1 ( = 0.887). The values were 30.9 ± 4.9 and 30.5 ± 5.6 ( = 0.773) respectively, by the UCLA scale. Crescent-shaped and L- or U-shaped supraspinatus tears have similar postoperative functional results. In the preoperative period, the functional results are superior in crescent-shaped tears.
评估脊柱上撕裂模式对术前和术后功能评估的影响。 一项回顾性队列研究，比较了患有冈上肌新月形撕裂与L形或U形撕裂的患者。我们纳入了接受完全冈上肌关节镜修复的患者。我们排除了接受肩胛下肌或冈下肌修复的患者、接受开放手术的患者或仅实现部分修复的患者。使用的临床量表是美国肩肘外科医生标准化肩部评估（ASES）和改良的加利福尼亚大学洛杉矶分校肩部评分量表（UCLA），在手术前1周和术后24个月应用。 我们分析了167个肩部（来自163名患者）。在术前阶段，新月形模式的ASES量表得分显著更高（43.5±17.6对37.7±13.8； =0.034）。UCLA量表遵循相同模式（15.2±4.6对13.5±3.6； =0.028）。然而，在术后阶段，没有显著差异。根据ASES量表，新月形撕裂得分为83.7±18.7分，L形或U形撕裂得分为82.9±20.1（ =0.887）。根据UCLA量表，相应的值分别为30.9±4.9和30.5±5.6（ =0.773）。 新月形和L形或U形冈上肌撕裂术后功能结果相似。在术前阶段，新月形撕裂的功能结果更好。
