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关节镜下自体肩锁韧带增强技术治疗至少两年随访的肩袖部分厚度撕裂。

Arthroscopic Autologous Coracoacromial Ligament Augment Technique for Particle Thickness of Rotator Cuff with at Least Two Years Follow-Up.

机构信息

Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Orthop Surg. 2023 Aug;15(8):2157-2166. doi: 10.1111/os.13697. Epub 2023 Mar 11.

Abstract

OBJECTIVE

Patch technology has been the new technique in the treatment of partial thickness of the rotator cuff tear (PTRCTs) to address the limitation of traditional techniques. Compared with allogeneic patches and artificial materials, coracoacromial ligament is obviously closer to their own biology. The purpose of the study was to evaluate the functional and radiographic outcomes following arthroscopic autologous coracoacromial ligament augment technique for treatment of PTRCTs.

METHOD

This study included three female patients with PTRCTs who underwent arthroscopy operation in 2017 with an average age of 51 years (range from 50 to 52 years). The coracoacromial ligament implant was attached to the bursal side surface of the tendon. The clinical results were evaluated by American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), acromiohumeral distance (AHD) and muscle strength before and 12 months after operation. Magnetic resonance imaging (MRI) was performed 24 months after operation to assess the integrity of the anatomical structure of the original tear site.

RESULT

The average ASES score improved significantly from 57.3 preoperatively to 95.0 at 1-year follow-up. The strength improved significantly from grade 3 preoperatively to grade 5 at 1 year. Two of three patients underwent the MRI at 2-year follow-up. Radiographic released the complete healing of rotator cuff tear. No implant-related serious adverse events were reported.

CONCLUSION

The new technique of using autogenous coracoacromial ligament patch augment provides good clinical results on patients with PTRCTs.

摘要

目的

补片技术是治疗部分厚度肩袖撕裂(PTRCTs)的新技术,可解决传统技术的局限性。与同种异体补片和人工材料相比,肩锁韧带明显更接近其自身生物学特性。本研究旨在评估关节镜下自体肩锁韧带增强技术治疗 PTRCTs 的功能和放射学结果。

方法

本研究纳入了 2017 年接受关节镜手术的 3 名 PTRCTs 女性患者,平均年龄 51 岁(范围 50-52 岁)。肩锁韧带移植物附着于肌腱的滑膜侧表面。通过美国肩肘外科医生协会(ASES)评分、简易肩部测试(SST)、肩峰肱骨头间距(AHD)和术前及术后 12 个月的肌肉力量来评估临床结果。术后 24 个月行磁共振成像(MRI)检查,评估原撕裂部位解剖结构的完整性。

结果

平均 ASES 评分从术前的 57.3 分显著提高到 1 年随访时的 95.0 分。肌力从术前 3 级显著提高到 1 年时的 5 级。3 例中有 2 例在 2 年随访时进行了 MRI 检查。影像学显示肩袖撕裂完全愈合。无与植入物相关的严重不良事件报告。

结论

使用自体肩锁韧带补片增强的新技术为 PTRCTs 患者提供了良好的临床结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72a0/10432468/627f16a95bcd/OS-15-2157-g006.jpg

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