Zhou Yi, She Hongjiang, Liu Xiaoyan, Wang Rui, Bai Fan
Department of Orthopaedics, Jian Yang Hospital of Traditional Chinese Medicine, Jian Yang, China.
Department of Orthopaedics, Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi City), Zunyi, China.
Orthop J Sports Med. 2023 Feb 16;11(2):23259671231152233. doi: 10.1177/23259671231152233. eCollection 2023 Feb.
Both remnant preservation (RP) and bone marrow stimulation (BMS) enhance the healing potential of the repaired rotator cuff by improving the biological milieu of the tendon-bone interface.
To evaluate the clinical and imaging outcomes of arthroscopic rotator cuff repair using a combined RP-BMS technique in patients with acute rotator cuff tears.
Cohort study; Level of evidence, 3.
Between January 2016 and June 2019, a total of 56 patients were diagnosed with acute rotator cuff tears; 29 patients underwent conventional repair (group 1), and 27 patients underwent RP-BMS (group 2). At a minimum follow-up period of 2 years, the authors compared clinical outcomes with the University of California-Los Angeles; Constant; American Shoulder and Elbow Surgeons; and pain visual analog scale scores as well as shoulder range of motion. Tendon integrity and retear were assessed on magnetic resonance imaging according to the Sugaya classification (intact, grades 1-3; retear, grades 4-5). Between-group comparisons were conducted using the Student test or Mann-Whitney test for continuous variables and the Pearson chi-square test or Fisher exact test for categorical variables.
In both groups, patients had significant preoperative to postoperative improvement on all clinical outcome measures ( = .001 for all). Shoulder abduction in group 2 was significantly greater compared with group 1 at the postoperative 3-month (107.37° ± 8.32° vs 95.44° ± 8.78°; = .001), 6-month (155.25° ± 10.02° vs 144.72° ± 9.28°; = .001), and final (165.15° ± 9.17° vs 158.31° ± 8.01°; = .021) follow-ups. At the final follow-up, significantly more patients in group 2 had intact tendons (Sugaya grades 1-3) compared with group 1 ( = .015), and the tendon retear rate was lower in group 2 (1/27; 3.70%) than in group 1 (7/29; 24.14%) ( = .033).
Both surgical techniques led to satisfactory clinical outcomes, but shoulder abduction was greater after the RP-BMS technique compared with conventional repair. RP-BMS may be an alternative surgical technique to improve tendon integrity and retear rates after the repair of acute rotator cuff tears.
残余组织保留（RP）和骨髓刺激（BMS）均通过改善肌腱-骨界面的生物学环境来增强修复的肩袖的愈合潜力。
评估在急性肩袖撕裂患者中使用RP-BMS联合技术进行关节镜下肩袖修复的临床和影像学结果。
队列研究；证据等级，3级。
2016年1月至2019年6月期间，共有56例患者被诊断为急性肩袖撕裂；29例患者接受传统修复（第1组），27例患者接受RP-BMS（第2组）。在至少2年的随访期内，作者将临床结果与加利福尼亚大学洛杉矶分校、Constant、美国肩肘外科医师协会的评分以及疼痛视觉模拟量表评分以及肩关节活动范围进行了比较。根据Sugaya分类（完整，1-3级；再撕裂，4-5级）在磁共振成像上评估肌腱完整性和再撕裂情况。对于连续变量，使用Student检验或Mann-Whitney检验进行组间比较；对于分类变量，使用Pearson卡方检验或Fisher精确检验进行组间比较。
在两组中，患者在所有临床结果指标上从术前到术后均有显著改善（所有指标P = 0.001）。在术后3个月（107.37°±8.32°对95.44°±8.78°；P = 0.001）、6个月（155.
