开放性和关节镜下肩袖修复术后肩袖完整性与肩峰下间隙的关系。
The relationship between rotator cuff integrity and acromiohumeral distance following open and arthroscopic rotator cuff repair.
作者信息
Kholinne Erica, Kwak Jae-Man, Sun Yucheng, Kim Hyojune, Park Dongjun, Koh Kyoung Hwan, Jeon In-Ho
机构信息
Faculty of Medicine, Trisakti University, Department of Orthopedic Surgery, St. Carolus Hospital, 11440 Jakarta, Indonesia - Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, 05505 Seoul, Republic of Korea.
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, 05505 Seoul, Republic of Korea.
出版信息
SICOT J. 2021;7:23. doi: 10.1051/sicotj/2021012. Epub 2021 Mar 26.
BACKGROUND
Acromiohumeral distance (AHD) has become both a diagnostic and prognostic parameter related to rotator cuff pathology which is always measured in a 2-dimensional plane. The purposes of this study were (1) to evaluate the regional AHD with MRI following open and arthroscopic rotator cuff repair and, (2) to investigate its association to the rotator cuff integrity following medium to large size rotator cuff repair with open and arthroscopic manner.
METHODS
A retrospective review of 112 patients who were treated for full-thickness medium to large size rotator cuff tears either by open repair (open group) or arthroscopic repair (arthroscopic group) was done. All patients included in the study are those with at least 12 and 18 months for the post-operative MRI and clinical follow-up. Propensity score matching was used to select controls matched for age, sex, body mass index, tear size, and affected site. There were 56 patients in each group with a mean age of 63.3 years (range, 50 to 77 years). The post-operative functional and radiologic outcomes for both groups were compared. AHD was measured at three regions of interest (ROI) with MRI and compared pre-and post-operatively.
RESULTS
AHD was significantly greater in the open group when measured at the anterior third of the lateral acromion border compare to the arthroscopic group (p = 0.005). The re-tear rate was affected by AHD at the anterior third of the lateral border of the acromion for the arthroscopic and open group (p = 0.021, p = 0.029). The AHD measured at the anterior and middle third of lateral acromion border were significantly greater in healed compared to the re-tear rotator cuff group (p = 0.019, p = 0.022).
CONCLUSIONS
Open rotator cuff repair showed greater AHD at the anterior third of the lateral border of the acromion. Regional AHD measured at anterior third of the lateral border of acromion significantly associated with rotator cuff integrity following repair.
LEVEL OF EVIDENCE
propensity-matched case-control (Level II).
背景
肩峰肱骨头距离（AHD）已成为与肩袖病变相关的诊断和预后参数，通常在二维平面上进行测量。本研究的目的是：（1）通过MRI评估开放和关节镜下肩袖修复术后的局部AHD；（2）研究在开放和关节镜下进行中到大尺寸肩袖修复术后，其与肩袖完整性的相关性。
方法
对112例接受全层中到大尺寸肩袖撕裂修复治疗的患者进行回顾性研究，其中开放修复组（开放组）和关节镜修复组（关节镜组）。纳入研究的所有患者术后MRI和临床随访时间至少分别为12个月和18个月。采用倾向评分匹配法选择年龄、性别、体重指数、撕裂大小和患侧部位相匹配的对照组。每组56例患者，平均年龄63.3岁（范围50至77岁）。比较两组术后的功能和影像学结果。通过MRI在三个感兴趣区域（ROI）测量AHD，并进行术前和术后比较。
结果
与关节镜组相比，在肩峰外侧缘前三分之一处测量时，开放组的AHD明显更大（p = 0.005）。关节镜组和开放组肩峰外侧缘前三分之一处的AHD影响再撕裂率（p = 0.021，p = 0.029）。与再撕裂肩袖组相比，在肩峰外侧缘前、中三分之一处测量的AHD在愈合组中明显更大（p = 0.019，p = 0.022）。
结论
开放肩袖修复在肩峰外侧缘前三分之一处显示出更大的AHD。在肩峰外侧缘前三分之一处测量的局部AHD与修复后肩袖完整性显著相关。
证据水平
倾向匹配病例对照研究（II级）。
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