Ji Jong-Hun, Parikh Darshil, Han Young-Hoon, You Hwang-Yong
Department of Orthopedic Surgery, College of Medicine, The Catholic university of Korea, Seoul, Republic of Korea.
Arthrosc Tech. 2023 Nov 6;12(12):e2161-e2168. doi: 10.1016/j.eats.2023.07.042. eCollection 2023 Dec.
Revision repair of retorn partial articular supraspinatus tendon avulsion (PASTA) lesion is difficult for poor tendon quality without tear completion and repair. Trans-tendon suture bridge repair with biceps tendon augmentation can preserve the intact bursal side cuff attachment and has shown satisfactory clinical outcomes. Moreover, trans-tendon suture bridge rotator cuff repair technique, along with biceps tendon augmentation, reinforces high-grade PASTA lesions by moving the tenotomized biceps tendon into the torn articular side cuff defect with added advantage of blood supply through the tenotomized biceps tendon graft. Retear after trans-tendon repair of high-grade PASTA lesions was rare, and its poor tendon quality cause the revision repair to be too difficult. Without tear completion and rotator cuff repair, this arthroscopic trans-tendon suture bridge rotator cuff repair with biceps tendon augmentation is a reliable procedure that could be expected to produce improved short-term functional and radiologic outcomes, along with improved tendon quality of repaired tendon.
对于未完全撕裂且无法修复、肌腱质量较差的冈上肌部分关节面肌腱撕脱(PASTA)损伤进行翻修修复很困难。采用肱二头肌肌腱增强的经肌腱缝合桥修复可保留完整的滑囊侧袖带附着,且已显示出令人满意的临床效果。此外,经肌腱缝合桥肩袖修复技术,连同肱二头肌肌腱增强,通过将切断的肱二头肌肌腱移入撕裂的关节侧袖带缺损处,加强了高级别PASTA损伤的修复,还具有通过切断的肱二头肌肌腱移植物提供血供的额外优势。高级别PASTA损伤经肌腱修复后的再撕裂很少见,而其较差的肌腱质量导致翻修修复过于困难。在未完全撕裂且未进行肩袖修复的情况下,这种采用肱二头肌肌腱增强的关节镜下经肌腱缝合桥肩袖修复是一种可靠的手术方法,有望产生改善的短期功能和影像学结果,以及提高修复肌腱的质量。