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对接受关节镜下初次修复或关节镜下补片增强术治疗大至巨大肩袖撕裂的肩袖再撕裂患者的临床结果比较。

A Comparison of Clinical Outcomes in Rotator Cuff Re-Tear Patients Who Had Either an Arthroscopic Primary Repair or Arthroscopic Patch Augmentation for Large-to-Massive Rotator Cuff Tears.

作者信息

Kim Ki-Tae, Kim Gwan-Ho, Cha Dong-Heon, Lee Jae-Hoo, Lee Yong-Beom

机构信息

Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Republic of Korea.

出版信息

Diagnostics (Basel). 2023 Jun 4;13(11):1961. doi: 10.3390/diagnostics13111961.

Abstract

BACKGROUND AND PURPOSE

Despite the prevalent incidence of re-tear following rotator cuff repair, there is a notable lack of comparative studies investigating the outcomes between patients with re-tear who underwent primary repair versus those who received patch augmentation for large-to-massive tears. We assessed clinical outcomes of these techniques through a retrospective, randomized controlled trial.

METHODS

134 patients diagnosed with large-to-massive rotator cuff tears from 2018 to 2021 underwent surgery; 65 had primary repair and 69 had patch augmentation. A total of 31 patients with re-tears were included, split into two groups; Group A (primary repair, 12 patients) and Group B (patch augmentation, 19 patients). Outcomes were evaluated using several clinical scales and MRI imaging.

RESULTS

Most clinical scores improved postoperatively in both groups. No significant difference in clinical outcomes was observed between groups, except for pain visual analog scale (P-VAS) scores. P-VAS scores showed greater decrease in the patch-augmentation group, a statistically significant difference.

CONCLUSIONS

for large-to-massive rotator cuff tears, patch augmentation led to greater decreases in pain than primary repair, despite similar radiographic and clinical results. Greater tuberosity coverage of the supraspinatus tendon footprint may impact P-VAS scores.

摘要

背景与目的

尽管肩袖修复术后再撕裂的发生率很高,但对于初次修复的再撕裂患者与接受补片增强修复巨大肩袖撕裂患者的预后进行比较研究却明显不足。我们通过一项回顾性随机对照试验评估了这些技术的临床疗效。

方法

2018年至2021年期间,134例被诊断为巨大肩袖撕裂的患者接受了手术;65例接受初次修复,69例接受补片增强修复。共有31例再撕裂患者被纳入研究,分为两组;A组(初次修复,12例患者)和B组(补片增强修复,19例患者)。使用多种临床量表和MRI成像对疗效进行评估。

结果

两组患者术后多数临床评分均有所改善。除疼痛视觉模拟量表(P-VAS)评分外,两组间临床疗效无显著差异。P-VAS评分在补片增强修复组下降幅度更大,差异具有统计学意义。

结论

对于巨大肩袖撕裂,尽管影像学和临床结果相似,但补片增强修复比初次修复能更大程度地减轻疼痛。冈上肌腱足迹更大的结节覆盖范围可能会影响P-VAS评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cbc/10252603/d80c613d4a36/diagnostics-13-01961-g001.jpg

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