Binder Harald, Buxbaumer Peter, Steinitz Amir, Waibl Bernhard, Sonnenschein Martin, Hackl Michael, Buess Eduard
Department of Orthopedics and Trauma Surgery, Division of Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Department of Trauma Surgery, Lorenz Böhler - Vienna, Vienna, Austria.
Arthrosc Sports Med Rehabil. 2022 Oct 31;4(6):e2025-e2034. doi: 10.1016/j.asmr.2022.09.002. eCollection 2022 Dec.
To compare the clinical and imaging outcome of arthroscopic transosseous (TO)-equivalent rotator cuff repair (RCR) with anchors with arthroscopic anchorless TO RCR at a minimum of 2 years postoperatively.
The study population included patients who underwent RCR using either an anchorless TO technique with a TO suture passing device (group A) and those who were matched for tear size and underwent RCR using suture anchors for repair (group B). The inclusion criterion was an easily reducible rotator cuff tear with a sagittal extension of 2 to 4 cm. After a minimum of 2 years, clinical outcome scores and magnetic resonance imaging were obtained. Tendon quality and footprint integration were evaluated using the Sugaya classification.
Seventy patients were included. A total of 45 were in group A and 25 were in group B. Group A had 2 bone tunnels and 4 sutures using an X-box configuration, and group B had a suture bridge construct of 4 anchors. Group A and B had identical anteroposterior tear size and were comparable for age. The Constant score improved from 50 ± 17.4 to 88 ± 8.6 in group A versus 48 ± 14.5 to 87 ± 7.2 in B. The Subjective Shoulder Value rose from 47 ± 19.1 to 95 ± 7.4 in group A vs from 47 ± 19.4 to 95 ± 7.6 in B. Neither the preoperative ( ≥ .502) nor postoperative scores ( ≥ .29) showed a significant difference. Magnetic resonance imaging showed 2 small retears in group A and one in B, resulting in an identical 4% retear rate. The mean Sugaya type was 2.02 versus 2.24 ( = .206) for groups A versus B.
Anchorless TO RCR is a valid alternative to suture anchor techniques. Clinical outcome data showed comparable results for both techniques after a follow-up of 2 years. The healing results as observed on magnetic resonance imaging were also equivalent for both groups.
Level III, retrospective comparative study.
比较关节镜下经骨（TO）等效性肩袖修复术（RCR）使用锚钉与关节镜下无锚钉TO RCR在术后至少2年时的临床和影像学结果。
研究人群包括使用带TO缝线通过装置的无锚钉TO技术进行RCR的患者（A组）以及那些撕裂大小匹配且使用缝线锚钉进行修复的RCR患者（B组）。纳入标准为矢状面延伸2至4 cm的易于复位的肩袖撕裂。至少2年后，获得临床结果评分和磁共振成像。使用Sugaya分类评估肌腱质量和骨床整合情况。
纳入70例患者。A组共45例，B组25例。A组使用X形配置有2个骨隧道和4根缝线，B组有4个锚钉的缝线桥结构。A组和B组前后向撕裂大小相同，年龄相当。A组Constant评分从50±17.4提高到88±8.6，B组从48±14.5提高到87±7.2。主观肩关节评价值A组从47±19.1提高到95±7.4，B组从47±19.4提高到95±7.6。术前（≥0.502）和术后评分（≥0.29）均无显著差异。磁共振成像显示A组有2处小的再撕裂，B组有1处，再撕裂率均为4%。A组和B组的平均Sugaya类型分别为2.02和2.24（P = 0.206）。
无锚钉TO RCR是缝线锚钉技术的有效替代方法。临床结果数据显示，两种技术在随访2年后结果相当。磁共振成像观察到的两组愈合结果也相当。
III级，回顾性比较研究。
