肩袖镜修补术中缝线桥和双排修复技术中残端分类与再撕裂相关。
Stump classification was correlated with retear in the suture-bridge and double-row repair techniques for arthroscopic rotator cuff repair.
机构信息
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan.
Department of Orthopaedic Surgery, Kitakyushu Municipal Medical Center, Kitakyushu City, Fukuoka, 802-0077, Japan.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2587-2594. doi: 10.1007/s00167-020-06415-5. Epub 2021 Jan 18.
PURPOSE
The Stump classification is significantly correlated with a retear after arthroscopic rotator cuff repair. However, no study has evaluated whether or not the stump classification is correlated with retear in the suture-bridge or double-row repair techniques. The aim of this study was to evaluate the relationship between a retear and the stump classification in the suture-bridge and double-row repair techniques.
METHODS
Among 389 patients who underwent arthroscopic repairs of full-thickness rotator cuff tears using suture-bridge or double-row repair techniques, 326 patients (median age 67.0 years; range 25-85) were included. There were 51 small, 172 medium, 83 large, and 20 massive tears. Two hundred forty patients were treated with the suture-bridge technique, and 86 patients were treated with the double-row technique. The following variables were analyzed: age, sex, the Cofield classification, anteroposterior and mediolateral tear size on preoperative MRI, global fatty degeneration index, and the stump classification. Cuff integrity was evaluated on magnetic resonance imaging at 6 months after surgery. The patients were divided into the intact and retear groups and the relationship between the variables and retear was evaluated by multivariate logistic regression analysis.
RESULTS
The overall retear rate was 10.1%. In the multivariate logistic regression analysis, the independent predictors of a retear were the stump classification type 3 (Odds ratio: 4.71, p = 0.0246), global fatty degeneration index (Odds ratio: 3.87, p = 0.0030), and anteroposterior tear size (Odds ratio: 1.07, p = 0.0077) in the suture bridge technique. In the double-row technique, the independent predictors of retear were stump classification type 3 (Odds ratio: 7.82, p = 0.0348), and age (Odds ratio: 1.22, p = 0.0163).
CONCLUSION
The stump classification was significantly correlated with retear in the suture-bridge and double-row repair technique. Stump classification type 3 was indicated to be an important risk factor for predicting retear.
LEVEL OF EVIDENCE
III.
目的
关节镜肩袖修复术后的 Stump 分类与再撕裂显著相关。然而，尚无研究评估 Stump 分类是否与缝合桥或双排修复技术中的再撕裂相关。本研究旨在评估缝合桥和双排修复技术中再撕裂与 Stump 分类之间的关系。
方法
在接受关节镜下全层肩袖撕裂修复的 389 例患者中，纳入了 326 例（中位年龄 67.0 岁；范围 25-85 岁）患者。其中小撕裂 51 例，中撕裂 172 例，大撕裂 83 例，巨大撕裂 20 例。240 例患者采用缝合桥技术治疗，86 例患者采用双排技术治疗。分析的变量包括年龄、性别、Cofield 分类、术前 MRI 的前后和内外侧撕裂大小、整体脂肪变性指数和 Stump 分类。术后 6 个月时通过磁共振成像评估肩袖完整性。将患者分为完整组和再撕裂组，通过多变量逻辑回归分析评估变量与再撕裂的关系。
结果
总的再撕裂率为 10.1%。多变量逻辑回归分析显示，再撕裂的独立预测因子是缝合桥技术中的 Stump 分类 3 型（优势比：4.71，p=0.0246）、整体脂肪变性指数（优势比：3.87，p=0.0030）和前后撕裂大小（优势比：1.07，p=0.0077）。在双排技术中，再撕裂的独立预测因子是 Stump 分类 3 型（优势比：7.82，p=0.0348）和年龄（优势比：1.22，p=0.0163）。
结论
Stump 分类与缝合桥和双排修复技术中的再撕裂显著相关。Stump 分类 3 型表明是预测再撕裂的一个重要危险因素。
证据等级
III 级。
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