Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Faculty of Medicine, Universitas Trisakti, Department of Orthopedic Surgery, St Carolus Hospital, Jakarta, Indonesia.
Am J Sports Med. 2023 Mar;51(4):912-918. doi: 10.1177/03635465231151927. Epub 2023 Feb 14.
Recently, a polypropylene mesh has been introduced and reported to improve clinical outcomes after superior capsular reconstruction (SCR) using a fascia lata autograft (FLA). However, mesh-related events such as a foreign body response may trigger inflammation, which might affect graft healing and remodeling.
PURPOSE/HYPOTHESIS: The aim was to investigate whether the healing and remodeling of an FLA were affected by the use of a mesh by comparing the signal intensity of an FLA-alone group vs an FLA + Mesh group on postoperative magnetic resonance imaging (MRI). The hypothesis was that the use of a mesh would decrease the MRI signal intensity of FLA during the early postoperative phase.
Cohort study; Level of evidence, 3.
Patients who had undergone SCR using an FLA with or without a mesh between March 2013 and August 2021 were retrospectively analyzed. Follow-up MRI was performed at 3 months. A total of 78 patients (24 in the FLA group and 54 in the FLA + Mesh group) with intact grafts were included. Graft remodeling was evaluated by analyzing the signal-to-noise quotient (SNQ) at the humeral, mid-substance, and glenoid sites. Theoretically, lower SNQ ratios indicate higher strength and better healing of the graft.
The mean SNQ was 30.603 (range, 11.790-72.710) in the FLA group and 18.367 (range, 4.464-69.500) in the FLA + Mesh group ( < .001). Furthermore, significant differences were found between the 2 groups at the humeral and mid-substance sites (37.863 [range, 5.092-81.187] vs 15.512 [range, 1.814-80.869], < .001; and 29.168 [range, 6.103-73.900] vs 16.878 [range, 2.454-92.416], = .003; respectively). However, there was no difference between the 2 groups at the glenoid site (25.346 [range, 7.565-86.353] vs 20.354 [range, 3.732-88.468], = .057).
At the 3-month follow-up, the FLA + Mesh group showed a lower MRI signal intensity than the FLA group. The healing and remodeling of an FLA may be enhanced when a mesh is used.
最近，一种聚丙烯网片被引入并报道可改善使用阔筋膜移植物（FLA）进行的上方囊重建（SCR）后的临床结果。然而，网片相关事件，如异物反应，可能会引发炎症，从而影响移植物的愈合和重塑。
目的/假设：本研究旨在通过比较单纯 FLA 组与 FLA+网片组术后磁共振成像（MRI）的信号强度，来研究网片的使用是否会影响 FLA 的愈合和重塑。假设是使用网片会在术后早期降低 FLA 的 MRI 信号强度。
队列研究；证据水平，3 级。
回顾性分析了 2013 年 3 月至 2021 年 8 月间接受 FLA 联合或不联合网片行 SCR 的患者。术后 3 个月行 MRI 随访。共纳入 78 例（FLA 组 24 例，FLA+网片组 54 例），所有移植物完整。通过分析肱骨、中部和肩胛盂部位的信噪比（SNQ）评估移植物重塑情况。理论上，较低的 SNQ 比值表明移植物的强度更高，愈合更好。
FLA 组的平均 SNQ 为 30.603（范围，11.790-72.710），FLA+网片组为 18.367（范围，4.464-69.500）（<.001）。此外，2 组在肱骨和中部部位的 SNQ 差异具有统计学意义（37.863[范围，5.092-81.187]比 15.512[范围，1.814-80.869]，<.001；29.168[范围，6.103-73.900]比 16.878[范围，2.454-92.416]，=.003）。然而，2 组在肩胛盂部位的 SNQ 无差异（25.346[范围，7.565-86.353]比 20.354[范围，3.732-88.468]，=.057）。
在术后 3 个月时，FLA+网片组的 MRI 信号强度低于 FLA 组。使用网片可能会增强 FLA 的愈合和重塑。
