Dey Hazra Rony-Orijit, Dey Hazra Maria E, Hanson Jared A, Rutledge Joan C, Horan Marilee P, Rupp Marco-Christopher, Millett Peter J
Steadman Philippon Research Institute, Vail, CO, USA; Department for Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité - University Medicine Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Steadman Philippon Research Institute, Vail, CO, USA; Private Practice, Dr. Ulf Kuhlee, Berlin, Berlin, Germany.
J Shoulder Elbow Surg. 2024 Apr;33(4):832-840. doi: 10.1016/j.jse.2023.07.036. Epub 2023 Sep 1.
Although short-term results are promising, there are limited data for long-term results of arthroscopic subscapularis (SSC) repair. The purpose of this study is to report minimum 10-year outcomes of primary arthroscopic repair of isolated partial or full-thickness tears of the upper third of the SSC tendon.
Patients who underwent arthroscopic repair of isolated upper third SSC tears, Lafosse type I (>50% of tendon thickness) or type II were included. Surgeries were performed by a single surgeon between November 2005 and August 2011. Patient-reported outcome measures were prospectively collected and retrospectively reviewed at minimum follow-up of 10 years. Patient-reported outcomes utilized included the American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation score (SANE), Quick Disabilities of the Arm, Shoulder and Hand score (QuickDASH), the Short Form 12 physical component summary, return to activity, and patient satisfaction. A subanalysis of patient age and outcomes was performed. Retears, revision surgeries, and surgical complications were recorded.
In total, 29 patients with isolated upper third SSC repairs were identified. After application of exclusion criteria, 14 patients were included in the final analysis. Follow-up could be obtained from 11 patients. The mean age at surgery was 52.7 years (range: 36-72) and the mean follow-up was 12 years (range 10-15 years). The American Shoulder and Elbow Surgeons score improved from 52.9 ± 21.8 preoperatively to 92.2 ± 13.7 postoperatively (P < .001). Regarding the SANE and QuickDASH scores, only postoperative data were available. Mean postoperative SANE, QuickDASH, and Short Form 12 physical component summary scores were 90.27 ± 10.5, 14.6 ± 15.5, and 49.2 ± 6.6, respectively. Median patient satisfaction was 10 (range 6-10). Patients reported improvements in sleep, activities of daily living, and sports. There was no correlation between patient age and clinical outcome (P > .05). No patients underwent revision surgery for a SSC retear.
Arthroscopic repair of upper third SSC tendon tears leads to improved clinical scores and high patient satisfaction at minimum 10-year follow-up. The procedure is durable, with no failures in the presented cohort.
尽管短期结果令人鼓舞，但关于关节镜下肩胛下肌（SSC）修复的长期结果的数据有限。本研究的目的是报告孤立的SSC肌腱上三分之一部分或全层撕裂的初次关节镜修复的至少10年的结果。
纳入接受孤立的SSC上三分之一撕裂（Lafosse I型（>肌腱厚度的50%）或II型）关节镜修复的患者。手术由一名外科医生在2005年11月至2011年8月期间进行。前瞻性收集患者报告的结局指标，并在至少10年的随访后进行回顾性分析。使用的患者报告结局包括美国肩肘外科医生评分、单评估数字评价评分（SANE）、手臂、肩部和手部快速残疾评分（QuickDASH）、简短健康调查12项身体成分汇总评分、恢复活动情况和患者满意度。对患者年龄和结局进行了亚分析。记录再撕裂、翻修手术和手术并发症。
共确定29例孤立的SSC上三分之一修复患者。应用排除标准后，14例患者纳入最终分析。可获得11例患者的随访。手术时的平均年龄为52.7岁（范围：36 - 72岁），平均随访时间为12年（范围10 - 15年）。美国肩肘外科医生评分从术前的52.9±21.8提高到术后的92.2±13.7（P <.001）。关于SANE和QuickDASH评分，仅获得术后数据。术后SANE、QuickDASH和简短健康调查12项身体成分汇总评分的平均值分别为90.27±10.5、14.6±15.5和49.2±6.6。患者满意度中位数为10（范围6 - 10）。患者报告睡眠、日常生活活动和运动方面有所改善。患者年龄与临床结局之间无相关性（P >.05）。没有患者因SSC再撕裂而接受翻修手术。
关节镜修复SSC肌腱上三分之一撕裂在至少10年随访时可提高临床评分并获得较高的患者满意度。该手术效果持久，在本队列中无失败病例。
