[肩袖撕裂肩关节上盂唇重建移植物的适应证及治疗研究进展]
[Research progress of indication and treatment of graft in shoulder superior capsular reconstruction for rotator cuff tear].
作者信息
Li Huaisheng, Yang Mingyu, Li Yan, Zhou Binghua, Tang Kanglai
机构信息
Department of Sports Medicine, the First Affiliated Hospital of the Army Military Medical University, Chongqing, 400038, P.R.China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021 Feb 15;35(2):252-257. doi: 10.7507/1002-1892.202006015.
OBJECTIVE
To review the research progress of indication and treatment of graft in shoulder superior capsular reconstruction (SCR) for rotator cuff tear (RCT).
METHODS
The literature related to shoulder SCR in recent years was extensively reviewed, and the anatomy, biomechanics, surgical indications, and treatment of graft in SCR were summarized.
RESULTS
Superior capsule plays a role as a functional complex with rotator cuff, ligament, and whole capsule. SCR can effectively restore the superior stability of the shoulder. The indications of SCR include the irreparable massive RCT, massive RCT combined with pseudoparalysis shoulder, medium/large RCT with severe degenerative rotator cuff tissue, and dual-layer RCT. In order to achieve a better healing of tendon-bone in graft and decrease the rate of long-term graft retearing, it is essential to select an appropriate thickness graft, fix the graft in right intensity, and get a better capsular continuity.
CONCLUSION
The technique of SCR advanced to SCR for reinforcement and it is indicated from substantial massive RCT to severe degeneration of rotator cuff tissue. Graft treatment is the key step for a successful SCR.
目的
回顾肩袖撕裂（RCT）的肩关节上盂唇重建（SCR）中移植物的适应证及治疗的研究进展。
方法
广泛回顾近年来与肩关节SCR相关的文献，总结SCR的解剖、生物力学、手术适应证及移植物治疗。
结果
上盂唇与肩袖、韧带及整个关节囊构成一个功能复合体。SCR能有效恢复肩关节的上方稳定性。SCR的适应证包括不可修复的巨大RCT、巨大RCT合并假性麻痹肩、伴有严重退变肩袖组织的中/大型RCT以及双层RCT。为使移植物腱骨更好愈合并降低移植物长期再撕裂率，选择合适厚度的移植物、以适当强度固定移植物并获得更好的关节囊连续性至关重要。
结论
SCR技术发展为强化的SCR，适应证从实质性巨大RCT扩展到肩袖组织严重退变。移植物治疗是SCR成功的关键步骤。
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