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使用全缝线锚钉作为内侧排锚钉进行肩袖修复的临床和影像学结果

Clinical and Radiological Outcomes of Rotator Cuff Repairs Using All-Suture Anchors as Medial Row Anchors.

作者信息

Memon Kashif A, Dimock Richard, Bernasconi Alessio, Sobti Anshul, Consigliere Paolo, Imam Mohamed A, Narvani A Ali

机构信息

Rowley Bristow Unit, Ashford and St Peter's NHS Trust, Chertsey, United Kingdom.

Orthopaedic and Traumatology Unit, University "Federico II" of Naples, Naples, Italy.

出版信息

Arch Bone Jt Surg. 2021 Sep;9(5):527-535. doi: 10.22038/abjs.2021.52827.2654.

Abstract

BACKGROUND

The aim of our study is to report the clinical and radiological outcomes of a series of prospectively enrolled patients who have had double-row transosseous equivalent rotator cuff repairs, where all-suture anchors were used as medial-row anchors, with a minimum follow-up of 1 year.

METHODS

Twenty-two consecutive patients underwent arthroscopic transosseous equivalent double-row rotator cuff repair using all-suture anchors as medial-row anchors. Oxford Shoulder Score, Constant Score and Visual Analogue Scale pain score, together with shoulder range of motion, were used preoperatively and at 3 months, 6 months and final follow-up. Radiological evaluation was performed with magnetic resonance imaging at one-year post surgery to assess the structural integrity of the repair and the rate of cyst formation in greater tuberosity.

RESULTS

The patient mean age was 61 years (range 46-75). Minimum follow-up was 1 year, and the mean final follow-up was 15 months (range 12-24). Healing failure in our patients was less than 5% (1/22 patients). There were significant improvements in shoulder function outcome scores at final follow-up. The Constant and Oxford scores were 78 and 44 at final follow-up respectively. There were similar magnitudes of improvement in range of motion (combined abduction and rotation), pain score and supraspinatus strength at final follow up. The improvements in outcome scores were already statistically significant at 3 months (). Using Kim's classification for cyst formation on T2-weighted MRI images, we observed no fluid or minimal fluid collection in 85% of the patients (17/22 patients). There were no correlations between the grade of bone changes and the clinical outcomes.

CONCLUSION

It is safe to use all-suture anchors as medial-row anchors when performing double-row anchor transosseous equivalent rotator cuff repairs. The purported advantages of all-suture anchors may outweigh their perceived disadvantages in rotator cuff repair surgery.

摘要

背景

我们研究的目的是报告一系列前瞻性纳入的患者接受双排经骨等效性肩袖修补术的临床和放射学结果,其中所有缝线锚钉均用作内侧排锚钉,且最短随访时间为1年。

方法

22例连续患者接受了关节镜下经骨等效性双排肩袖修补术,使用所有缝线锚钉作为内侧排锚钉。术前以及术后3个月、6个月和最终随访时使用牛津肩部评分、Constant评分和视觉模拟量表疼痛评分,以及肩部活动范围。术后1年进行磁共振成像放射学评估,以评估修补的结构完整性和大结节处囊肿形成率。

结果

患者平均年龄为61岁(范围46 - 75岁)。最短随访时间为1年,平均最终随访时间为15个月(范围12 - 24个月)。我们患者的愈合失败率低于5%(22例患者中的1例)。最终随访时肩部功能结果评分有显著改善。最终随访时Constant评分和牛津评分分别为78分和44分。最终随访时活动范围(外展和旋转综合)、疼痛评分和冈上肌力量的改善幅度相似。结果评分在3个月时就已经具有统计学意义()。使用Kim对T2加权MRI图像上囊肿形成的分类,我们观察到85%的患者(22例患者中的17例)没有液体或仅有少量液体聚集。骨改变程度与临床结果之间没有相关性。

结论

在进行双排锚钉经骨等效性肩袖修补术时,使用所有缝线锚钉作为内侧排锚钉是安全的。在肩袖修补手术中,所有缝线锚钉的所谓优点可能超过其被认为的缺点。

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