Chen Sun-Yu, Xiao Zhao-Hao, Wang Jian-Kun
Department of Sports Medicine, the Second Hospital of Fuzhou, Fuzhou 350007, Fujian, China.
Zhongguo Gu Shang. 2022 Mar 25;35(3):203-8. doi: 10.12200/j.issn.1003-0034.2022.03.002.
To compare the effect of two different arthroscopic procedures, threading lasso fixation and full-thickness conversion, for repairing articular-sided partial-thickness supraspinatus tendon tear.
From July 2015 to November 2018, 21 patients with articular-sided partial-thickness supraspinatus tendon tears underwent arthroscopic modified threading lasso fixation repair(group A). There were 12 males and 9 females in the group, with an average age of(53.2±6.4)years old. Twenty-four patients with articular-sided partial-thickness supraspinatus tendon tears received arthroscopic full-thickness conversion repair(group B). In this group, there were 14 males and 10 females, with an average age of (55.7±5.2) years old. The American Shoulder and Elbow Surgeons (ASES) score and University of California Los Angeles (UCLA) shoulder score were used to evaluate preoperative and postoperative clinical function. MRI was used to examine the healing status of the reconstructed rotator cuff.
All patients were followed up, and the duration ranged from 20 to 27 months, with a mean of (23.7±3.1) months. In threading lasso fixation group, ASES score and UCLA score increased from 50.6±6.4 and 15.6±2.7 preoperatively to 87.3±5.2 and 31.6±2.4 postoperatively. In full-thickness conversion group, ASES score and UCLA score increased from 52.3±5.6 and 16.8±2.4 scores to 90.1±4.8 and 32.1±2.8. There were also no significant differences in ASES score and Constant score between the two groups before and after operation. There were no significant differences in rotator cuff healing between the two groups(=2.374, =0.128).
For the treatment of articular-sided partial-thickness supraspinatus tendon tears both arthroscopic repairs employing threading lasso fixation and full-thickness conversion could achieve satisfactory clinical results, and there are no significant differences in clinical outcomes between the two techniques. Arthroscopic repair with threading lasso fixation is a novel transtendinous procedure in which integrity of the tendon can be preserved.
比较两种不同的关节镜手术方法，即套索缝线固定术和全层转换术，修复关节侧部分厚度的冈上肌腱撕裂的效果。
2015年7月至2018年11月，21例关节侧部分厚度的冈上肌腱撕裂患者接受关节镜改良套索缝线固定修复术（A组）。该组男12例，女9例，平均年龄（53.2±6.4）岁。24例关节侧部分厚度的冈上肌腱撕裂患者接受关节镜全层转换修复术（B组）。该组男14例，女10例，平均年龄（55.7±5.2）岁。采用美国肩肘外科医师（ASES）评分和加州大学洛杉矶分校（UCLA）肩部评分评估术前和术后的临床功能。采用MRI检查重建肩袖的愈合情况。
所有患者均获随访，随访时间20～27个月，平均（23.7±3.1）个月。套索缝线固定组ASES评分和UCLA评分分别由术前的50.6±6.4和15.6±2.7提高至术后的87.3±5.2和31.6±2.4。全层转换组ASES评分和UCLA评分分别由52.3±5.6和16.8±2.4提高至90.1±4.8和32.1±2.8。两组手术前后ASES评分和Constant评分差异均无统计学意义。两组肩袖愈合情况差异无统计学意义（=2.374，=0.128）。
对于关节侧部分厚度的冈上肌腱撕裂，关节镜下套索缝线固定修复术和全层转换修复术均能取得满意的临床效果，两种技术的临床疗效差异无统计学意义。关节镜下套索缝线固定修复术是一种新型的经肌腱手术，可保留肌腱的完整性。
