Mirzayan Raffy
Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, USA.
Cureus. 2023 Jan 30;15(1):e34402. doi: 10.7759/cureus.34402. eCollection 2023 Jan.
Several treatment options exist for the treatment of massive, irreparable rotator cuff tears. A novel technique has been described whereby an acellular dermal allograft is secured to the greater tuberosity which acts as an interpositional tissue preventing bone-to-bone contact between the greater tuberosity and acromion. The preliminary results of this arthroscopic procedure are being presented.
Patients who underwent a biologic tuberoplasty procedure between 2015 and 2022, by a single surgeon, were included in this study. Pre- and postoperative American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and visual analogue pain scores (VAS) were prospectively recorded and retrospectively reviewed. Postoperative MRI was obtained in some cases. Paired t-test was used to calculate significance set at <0.05.
Ten patients met the inclusion criteria. The mean age was 70.4+4.7 years (range 65-78). There were five males. The mean length of follow-up was 21+27 months (range six to 95 months). There was significant improvement in ASES (24.3+4 to 91.5+10.3, P<0.00001), SANE (22.5+10.3 to 88+11.6, P<0.00001), and VAS (8.8+0.6 to 1.1+2.5, P<0.00001). MRI was obtained in seven patients at a mean of 5.3+2.9 months and showed a healed graft to the tuberosity in all cases.
Biologic tuberoplasty is an effective procedure in improving pain and functional outcomes in patients with massive, irreparable rotator cuff tears.
对于巨大、无法修复的肩袖撕裂,存在多种治疗选择。已描述了一种新技术,即通过将脱细胞真皮同种异体移植物固定于大结节,该移植物作为间置组织可防止大结节与肩峰之间发生骨对骨接触。本文介绍了该关节镜手术的初步结果。
本研究纳入了2015年至2022年间由同一位外科医生进行生物性结节成形术的患者。前瞻性记录并回顾性分析术前及术后美国肩肘外科医师学会(ASES)评分、单评估数字评定法(SANE)评分和视觉模拟疼痛评分(VAS)。部分患者术后进行了MRI检查。采用配对t检验计算显著性,设定P<0.05。
10例患者符合纳入标准。平均年龄为70.4±4.7岁(范围65 - 78岁)。男性5例。平均随访时间为21±27个月(范围6至95个月)。ASES评分(从24.3±4提高到91.5±10.3,P<0.00001)、SANE评分(从22.5±10.3提高到88±11.6,P<0.00001)和VAS评分(从8.8±0.6降低到1.1±2.5,P<0.00001)均有显著改善。7例患者在平均5.3±2.9个月时进行了MRI检查,结果显示所有病例移植物均已愈合至结节处。
生物性结节成形术是改善巨大、无法修复的肩袖撕裂患者疼痛和功能结局的有效手术。