Wellington Ian J, Muench Lukas N, Hawthorne Benjamin C, Uyeki Colin L, Antonacci Christopher L, McCarthy Mary Beth, Connors John P, Kia Cameron, Mazzocca Augustus D, Berthold Daniel P
Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT 06032, USA.
Department of Orthopedic Surgery, Technical University of Munich, 80333 Munich, Germany.
J Clin Med. 2022 May 24;11(11):2956. doi: 10.3390/jcm11112956.
Complex rotator cuff tears provide a significant challenge for treating surgeons, given their high failure rate following repair and the associated morbidity. The purpose of this study is to evaluate the clinical outcomes of patients who underwent biologically enhanced demineralized bone matrix augmentation of rotator cuff repairs. Twenty patients with complex rotator cuff tears underwent arthroscopic rotator cuff repair by a single surgeon with demineralized bone matrix (DBM) augmentation that was biologically enhanced with platelet-rich plasma and concentrated bone marrow aspirate. Post-operative MRI was used to determine surgical success. Patient reported outcome measures and range of motion data were collected pre-operatively and at the final post-operative visit for each patient. Ten patients (50%) with DBM augmentation of their arthroscopic rotator cuff repair were deemed non-failures. The failure group had less improvement of visual analogue pain scale ( = 0.017), Simple Shoulder Test ( = 0.032), Single Assessment Numerical Evaluation ( = 0.006) and abduction ( = 0.046). There was no difference between the groups for change in American Shoulder and Elbow Society score ( = 0.096), Constant-Murley score ( = 0.086), forward elevation ( = 0.191) or external rotation ( = 0.333). The present study found that 50% of patients who underwent biologically enhanced DBM augmentation of their rotator cuff repair demonstrated MRI-determined failure of supraspinatus healing.
复杂的肩袖撕裂给外科医生的治疗带来了重大挑战，因为修复后的失败率很高且伴有相关的发病率。本研究的目的是评估接受生物增强脱矿骨基质增强肩袖修复术的患者的临床结果。20例复杂肩袖撕裂患者由一名外科医生进行关节镜下肩袖修复，并使用富含血小板血浆和浓缩骨髓抽吸物进行生物增强的脱矿骨基质（DBM）增强。术后MRI用于确定手术是否成功。术前和术后最后一次随访时收集每位患者的患者报告结局指标和活动范围数据。10例（50%）接受关节镜下肩袖修复DBM增强的患者被判定为未失败。失败组在视觉模拟疼痛量表（P = 0.017）、简单肩部测试（P = 0.032）、单项评估数值评定（P = 0.006）和外展（P = 0.046）方面改善较少。两组在美肩肘协会评分变化（P = 0.096）、Constant-Murley评分变化（P = 0.086）、前屈（P = 0.191）或外旋（P = 0.333）方面无差异。本研究发现，50%接受生物增强DBM增强肩袖修复术的患者在MRI上显示冈上肌愈合失败。
