Crabtree Reaves M, Field Larry D
Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, U.S.A.
Arthrosc Tech. 2023 Jul 31;12(8):e1429-e1436. doi: 10.1016/j.eats.2023.04.013. eCollection 2023 Aug.
Attempts to restore the anatomical footprint during rotator cuff repair for retracted, relatively immobile tears can be difficult. In some cases, it can lead to excessive tension of the repair. Previous studies have noted improved clinical outcomes when repair tension is not excessive, and medialization of the anatomical footprint has been suggested as a technique that can help surgeons repair large, retracted tears without excessive tension and achieve improved clinical outcomes. Of note, excessive tension when restoring the rotator cuff tendon to the anatomical footprint is not limited to large, retracted tears. In some cases, restoring small- and medium-sized tears to the anatomical footprint also can lead to excessive tension. Therefore, it is not uncommon for the authors to employ some degree of footprint medialization even for repair of small- or medium-sized tears if repair to the anatomical footprint will lead to excess tension. The purpose of this article and video demonstration is to provide instruction for a reproducible rotator cuff technique using a medialized single-row rip-stop construct combined with convergence.
对于回缩且相对固定不动的肩袖撕裂进行修复时,试图恢复解剖足迹可能会很困难。在某些情况下,这可能会导致修复处张力过大。先前的研究指出,当修复张力不过大时,临床结果会有所改善,并且有人提出将解剖足迹向内侧移位作为一种技术,可帮助外科医生在不过度张力的情况下修复大型回缩撕裂,并取得更好的临床结果。值得注意的是,将肩袖肌腱恢复到解剖足迹时的过度张力并不局限于大型回缩撕裂。在某些情况下,将中小型撕裂恢复到解剖足迹也可能导致过度张力。因此,如果修复到解剖足迹会导致过度张力,即使是修复中小型撕裂,作者采用一定程度的足迹内侧移位也并不罕见。本文和视频演示的目的是提供一种可重复的肩袖技术指导,该技术使用内侧化的单排防撕裂结构并结合汇聚技术。