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无假性麻痹的有症状不可修复性肩袖肌腱撕裂的关节镜下结节成形术的疗效

Outcomes of arthroscopic tuberoplasty for symptomatic irreparable rotator cuff tendon tear without pseudoparalysis.

作者信息

Pines Yaniv, Magone Kevin M, Ben-Ari Erel, Gordon Dan, Rokito Andrew S, Virk Mandeep S, Kwon Young W

机构信息

Department of Orthopedic Surgery, New York University Langone Orthopedic Hospital, New York, NY, USA.

出版信息

JSES Int. 2022 Jul 16;6(6):1005-1010. doi: 10.1016/j.jseint.2022.06.007. eCollection 2022 Nov.

Abstract

BACKGROUND

The purpose of this study is to report the outcomes in patients undergoing arthroscopic tuberoplasty for symptomatic irreparable rotator cuff tear (RCT).

METHODS

This is a retrospective cohort study comparing preoperative and postoperative data of patients undergoing arthroscopic tuberoplasty for symptomatic irreparable RCT. Exclusion criteria included open tuberoplasty, concomitant partial RCT repair, glenohumeral arthritis, concomitant ipsilateral extremity fractures, <12 months follow-up, or pseudoparalysis. Demographics, shoulder range of motion (ROM), RCT morphology, re-operation rates, satisfaction and outcome scores were collected from medical records and questionnaires. Outcome scores included Patient Reported Outcome Measurement Information System Upper Extremity (PROMIS), American Shoulder and Elbow Surgeons score (ASES), Subjective Shoulder Value (SSV), and pain Visual Analog Score (VAS).

RESULTS

Out of 28 patients identified between 2012 and 2019, 20 (21 shoulders) were available for follow-up at a mean of 43.3 ± 20.9 months. Mean age was 64.6 ± 8.8 years. Mean PROMIS was 37.7 ± 7.3, ASES was 82.9 ± 13.8, and SVV was 67.1 ± 19.4. VAS with activity decreased from 5.0 ± 2.9 preoperatively to 2.3 ± 2.6 ( = .0029). Pre- and post-operative ROM were unchanged. There were 4 failures requiring revision. The remaining 17 patients reported high satisfaction scores (3.4 ± 0.7) and 15 (88.2%) answered "yes" to getting the procedure again, with 3/4 failures stating they would also undergo arthroscopic tuberoplasty again.

CONCLUSION

Arthroscopic tuberoplasty demonstrates high levels of satisfaction and pain reduction in symptomatic irreparable RCT. In appropriately indicated patients, this treatment should be considered prior to other salvage options.

摘要

背景

本研究的目的是报告因有症状的不可修复性肩袖撕裂(RCT)而接受关节镜下结节成形术患者的治疗结果。

方法

这是一项回顾性队列研究,比较因有症状的不可修复性RCT而接受关节镜下结节成形术患者的术前和术后数据。排除标准包括开放性结节成形术、同时进行部分RCT修复、盂肱关节炎、同侧肢体骨折、随访时间<12个月或假性麻痹。从病历和问卷中收集人口统计学资料、肩部活动范围(ROM)、RCT形态、再次手术率、满意度和结果评分。结果评分包括患者报告的结果测量信息系统上肢(PROMIS)、美国肩肘外科医生评分(ASES)、主观肩部价值(SSV)和疼痛视觉模拟评分(VAS)。

结果

在2012年至2019年间确定的28例患者中,20例(21个肩部)可进行随访,平均随访时间为43.3±20.9个月。平均年龄为64.6±8.8岁。平均PROMIS为37.7±7.3,ASES为82.9±13.8,SVV为67.1±19.4。活动时的VAS从术前的5.0±2.9降至2.3±2.6(P = .0029)。术前和术后ROM无变化。有4例失败需要翻修。其余17例患者报告了较高的满意度评分(3.4±0.7),15例(88.2%)回答如果再次进行该手术会选择“是”,4例失败患者中有3例表示他们也会再次接受关节镜下结节成形术。

结论

关节镜下结节成形术在有症状的不可修复性RCT患者中显示出较高的满意度和疼痛减轻效果。对于适当选择的患者,在考虑其他挽救性治疗方案之前应考虑这种治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/262e/9637579/90076e31526e/gr1.jpg

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