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Acta Biomed. 2022 Mar 10;92(S3):e2021584. doi: 10.23750/abm.v92iS3.12558.
The treatment of irreparable massive rotator cuff tears (MIRCTs) represents a challenge for the orthopedic surgeon both for the affected population and for the intrinsic characteristics of the injury. There are different types of treatment ranging from bursectomy to reverse shoulder prosthesis and subacromial spacers. The aim of the work is to establish the clinical and functional improvement of patients treated with subacromial spacer.
we conducted 2 studies: the first analyzing a sample of 24 patients (14 females and 10 male, mean age 65.7 years) operated between 2015 and 2017 whose last follow up dates back to October 2021 and a second one analyzing 55 patients (including patients of the first sample) (30 females and 25 males, mean age 64 years) over a period of time from 2015 to 2021. The mean follow up was 56 months. All patients were diagnosed with irreparable massive rotator cuff tears and treated with subacromial spacer.
the result in both studies was an increase of Constant score, tripled from the pre-operative values, in ROM, doubled, and a reduction of VAS.
the clinical results are encouraging and the use of the subacromial spacer could be a valid surgical alternative for patients with MIRCTs. However, we needed randomized trials with long-term follow-up.
对于骨科医生来说，治疗无法修复的巨大肩袖撕裂（MIRCT）是一个挑战，这既是因为受影响的人群，也是因为损伤的内在特征。治疗方法有多种，从滑囊切除术到反向肩假体和肩峰下间隙撑开器。本研究的目的是确定使用肩峰下间隙撑开器治疗的患者的临床和功能改善情况。
我们进行了两项研究：第一项研究分析了 2015 年至 2017 年间接受手术的 24 例患者（14 名女性和 10 名男性，平均年龄 65.7 岁）的样本，最后一次随访时间为 2021 年 10 月；第二项研究分析了 55 例患者（包括第一项研究中的患者）（30 名女性和 25 名男性，平均年龄 64 岁）的样本，时间跨度为 2015 年至 2021 年。平均随访时间为 56 个月。所有患者均被诊断为无法修复的巨大肩袖撕裂，并接受肩峰下间隙撑开器治疗。
两项研究的结果均为 Constant 评分增加，是术前值的三倍，ROM 增加一倍，VAS 降低。
临床结果令人鼓舞，肩峰下间隙撑开器的使用可能是 MIRCT 患者的一种有效手术选择。然而，我们需要进行长期随访的随机试验。
