Zhang Guang-Rui, Liu Jia-Xin, Zhou Jian-Ping, Wu Ding, Zhang Ming-Tao, An Li-Ping, Yun Xiang-Dong
Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou 730030, Gansu, China.
Zhongguo Gu Shang. 2021 Feb 25;34(2):160-4. doi: 10.12200/j.issn.1003-0034.2021.02.013.
Shoulder arthroscopic as a conventional method usually is applied to repair rotator cuff tears. In clinical, plenty single-row, double-row and transosseous tunnels suture technique are performed, but the ideal suture technique for rotator cuff repair is not found. Compared with single-row, double-row has better strength in biomechanics property. As the two best suture technique among the single-row, massive cuff stitch and modified Mason-Allen suture have the strongest biomechanics property. Clinical trials indicate that double-row could improve healing rates, but there are no significant difference in clinical outcome functional scores. Transosseous tunnel techniques possess a better bio-mechanic property, which could improve regional micro-environment and induce tendon-bone healing. Transosseous tunnel techniques are better for small to media size rotator cuff tears and osteoporosis patient. The author suggest that optimal rotator cuff repair technique should performed according to skill of performer and individual of patient by analysing bio-mechanic properties, clinical outcome, operative complexity and patient situation. The technique should follow simple opertaion, rapid, less trauma, stable fixation and utility to perform.
肩关节镜检查作为一种传统方法通常用于修复肩袖撕裂。在临床上，进行了大量的单排、双排和经骨隧道缝合技术，但尚未找到理想的肩袖修复缝合技术。与单排相比，双排在生物力学性能方面具有更好的强度。作为单排中两种最佳的缝合技术，大块肩袖缝合和改良梅森-艾伦缝合具有最强的生物力学性能。临床试验表明，双排可以提高愈合率，但在临床结局功能评分方面没有显著差异。经骨隧道技术具有更好的生物力学性能，可以改善局部微环境并促进腱骨愈合。经骨隧道技术更适合中小型肩袖撕裂和骨质疏松患者。作者建议，应根据术者的技术和患者个体情况，通过分析生物力学性能、临床结局、手术复杂性和患者状况来选择最佳的肩袖修复技术。该技术应遵循操作简单、快速、创伤小、固定稳定且实用的原则。
