Woodmass Jarret M, Wagner Eric R, Welp Kathryn M, Chang Michelle J, Morissette Marc P, Higgins Laurence D, Warner Jon J P
Pan Am Clinic, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Orthopedic Surgery, Emory University, Atlanta, Georgia, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jun 8;4(4):e1261-e1268. doi: 10.1016/j.asmr.2022.03.004. eCollection 2022 Aug.
To evaluate the role of concomitant partial rotator cuff repair (RCR) (i.e., infraspinatus) on patient-reported clinical outcomes following superior capsule reconstruction (SCR).
Postoperative recovery outcomes of SCR alone were compared with SCR with concomitant infraspinatus rotator cuff repair (SCR+RCR) at 3, 6, 12, and 24 months. Patients were included if they had an SCR surgery with or without a concomitant infraspinatus repair. Patients were excluded if they did not have a minimum of 6 months' follow-up or if a preoperative baseline questionnaire was not performed. Outcome measures included pain visual analog scale, American Shoulder and Elbow Surgeons (ASES) Shoulder Function, ASES Shoulder Index, and Single Assessment Numeric Evaluation (SANE) score.
Overall, 180 patients were evaluated, including 163 patients who underwent SCR alone and 17 patients who underwent concomitant infraspinatus repair (SCR+RCR). There was no difference in demographic data including age, sex, and body mass index. The postoperative recovery curves demonstrated SCR alone and SCR+RCR both provide significantly improved pain and functional scores at 2 years postoperatively ( < .001). When we compared the 2 groups, SCR+RCR provided significantly improved ASES Index (87.6 vs 78.2, .048) and ASES Function (25.5 vs 21.7, = .02). There was no statistically significant difference in SANE scores (75.5 vs 64.2, = .07) at 24 months' follow-up.
SCR provides modest improvements in pain and function at 2 years postoperatively in patients with irreparable rotator cuff tears. Patients who underwent SCR and concomitant infraspinatus repair demonstrated significantly improved ASES Index and ASES Function scores and statistically nonsignificant improvement in SANE scores at 24 months postoperatively when compared with SCR alone.
III, retrospective cohort study.
评估同期进行部分肩袖修复术（RCR）（即冈下肌修复）对患者报告的上盂唇重建术（SCR）临床疗效的作用。
对比单纯SCR与同期行冈下肌肩袖修复的SCR（SCR+RCR）在3个月、6个月、12个月和24个月时的术后恢复情况。纳入接受了SCR手术（无论是否同期行冈下肌修复）的患者。若患者随访时间不足6个月或未进行术前基线问卷调查，则予以排除。疗效指标包括疼痛视觉模拟量表、美国肩肘外科医师学会（ASES）肩部功能评分、ASES肩部指数及单项评估数字评价（SANE）评分。
共评估了180例患者，其中163例仅接受了SCR，17例接受了同期冈下肌修复（SCR+RCR）。在年龄、性别和体重指数等人口统计学数据方面无差异。术后恢复曲线显示，单纯SCR和SCR+RCR在术后2年时均使疼痛和功能评分显著改善（P<0.001）。比较两组时，SCR+RCR的ASES指数显著改善（87.6对78.2，P=0.048），ASES功能评分也显著改善（25.5对21.7，P=0.02）。在24个月随访时，SANE评分无统计学显著差异（75.5对64.2，P=0.07）。
对于不可修复的肩袖撕裂患者，SCR在术后2年时可使疼痛和功能有适度改善。与单纯SCR相比，接受SCR并同期行冈下肌修复的患者在术后24个月时ASES指数和ASES功能评分显著改善，SANE评分虽有改善但无统计学意义。
III级，回顾性队列研究。
