Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, CPO Box 8044, Seoul, 03722, Korea.
Sci Rep. 2021 Apr 1;11(1):7425. doi: 10.1038/s41598-021-86800-3.
Although it is well known that repairing large or massive tears under tension may have an adverse effect on healing of the repaired tendons, only few studies have addressed this issue in medium-sized isolated supraspinatus full-thickness tear. The purpose of this study was to compare the clinical outcomes and structural integrity of arthroscopic rotator cuff repair with tension versus without it. This study retrospectively investigated 90 patients who underwent arthroscopic repair in a single-row for medium-sized isolated supraspinatus full-thickness tear. The patients were assigned to either repaired under tension (Group A, n = 38) or repaired without tension (Group B, n = 52) groups. Functional outcomes were assessed using the patient reported subjective values and the active range of motion (ROM). Postoperative radiographic evaluation was performed 6 months after the surgery to assess the structural integrity of the repaired tendons. Changes in the subjective shoulder scores from initial to 2 years after surgery showed no statistical significance between the two groups. The ROMs measured at initial and 2 years after surgery also showed no statistical difference between the two groups. Postoperative radiological evaluations found a significantly higher re-tear rate in Group A (28.9%, 11/38) than in Group B (9.6%, 5/52). The torn cuff tendons that were repaired under tension as retraction with limited mobility had significantly higher re-tear rate despite having immobilized for 6 weeks after surgery, but their clinical outcomes showed no significant difference from the outcomes of repaired tendons without tension.
尽管众所周知，在张力下修复大或巨大撕裂可能对修复后的肌腱愈合产生不利影响，但只有少数研究在中等大小的孤立肩袖全层撕裂中涉及这个问题。本研究旨在比较有张力和无张力修复关节镜肩袖修复的临床结果和结构完整性。本研究回顾性调查了 90 例在单排接受关节镜修复的中等大小孤立肩袖全层撕裂患者。患者被分为有张力修复组（A 组，n = 38）或无张力修复组（B 组，n = 52）。使用患者报告的主观值和主动活动范围（ROM）评估功能结果。术后 6 个月进行影像学评估，以评估修复肌腱的结构完整性。与术后 2 年相比，两组患者的主观肩部评分均无显著变化。术后 2 年测量的 ROM 也无统计学差异。术后影像学评估发现 A 组（28.9%，11/38）的再撕裂率明显高于 B 组（9.6%，5/52）。尽管术后固定 6 周，但在张力下修复的回缩且活动度有限的撕裂肩袖的再撕裂率明显更高，但它们的临床结果与无张力修复的肌腱的临床结果无显著差异。
