Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Korea.
The Department of Orthopaedic Surgery, Royal Brisbane and Women's Hospital, Butterfield St, Herston, QLD, Australia.
Knee Surg Sports Traumatol Arthrosc. 2023 Sep;31(9):4060-4067. doi: 10.1007/s00167-023-07454-4. Epub 2023 May 24.
This study aimed at comparing the outcomes of medium- to large-sized rotator cuff repairs performed using the suture bridge technique either with or without tape-like sutures, and single row techniques with conventional sutures.
A total of 135 eligible patients with medium to large rotator cuff tears were identified and analyzed retrospectively, from 2017 to 2019. Only repairs using all-suture anchors were included in the study. Patients were divided into the following three groups: single-row (SR) repair (N = 50), standard double-row suture bridge (DRSB) repair with conventional sutures (N = 35), and DRSB with tape-like sutures (N = 50). The average postoperative follow-up period was 26.3 ± 9.8 months (range, 18-37).
DRSB with tapes had the highest re-tear rate of 16% (8/50), but there was no significant difference with the re-tear rates observed in SR (8%, 4/50) and DRSB with conventional sutures (11.4%, 4/35) (n.s.). DRSB with tapes demonstrated higher rate of type 2 re-tears (10%) compared to type 1 re-tears (6%), but the other two groups showed either similar or higher rates of type 1 re-tears compared to that of type 2. Post-operative functional scores of the three groups improved significantly (all p < 0.05), but the differences between the groups were not statistically significant.
No clinical difference in functional outcomes and re-tear rates were observed in DRSB with tapes when compared with SR and DRSB using the conventional sutures. Tape-like DRSB suture which was expected to be superior by its biomechanical advantage was clinically non-superior to conventional DRSB suture. There were no significant differences in VAS scores and UCLA scores.
Level III.
本研究旨在比较使用缝线桥技术(带或不带类似胶带缝线)与单排技术(使用传统缝线)修复中到大尺寸肩袖撕裂的结果。
回顾性分析了 2017 年至 2019 年期间符合条件的 135 例中到大尺寸肩袖撕裂患者,仅纳入使用全缝线锚定修复的患者。将患者分为以下三组:单排修复(SR)组(N=50)、使用传统缝线的标准双排缝线桥(DRSB)修复组(N=35)和使用类似胶带缝线的 DRSB 修复组(N=50)。平均术后随访时间为 26.3±9.8 个月(范围 18-37 个月)。
带胶带的 DRSB 再撕裂率最高,为 16%(8/50),但与 SR(8%,4/50)和使用传统缝线的 DRSB(11.4%,4/35)的再撕裂率无显著差异(n.s.)。带胶带的 DRSB 显示出较高的 2 型再撕裂率(10%),而 1 型再撕裂率(6%)较低,但其他两组的 1 型再撕裂率均高于 2 型。三组患者术后功能评分均显著改善(均 P<0.05),但组间差异无统计学意义。
与 SR 和使用传统缝线的 DRSB 相比,带胶带的 DRSB 在功能结果和再撕裂率方面没有临床差异。带胶带的 DRSB 缝线在生物力学上具有优势,预计会更好,但在临床上并不优于传统的 DRSB 缝线。VAS 评分和 UCLA 评分无显著差异。
III 级。