Lin Timothy
Arthroscopy. 2024 Feb;40(2):303-304. doi: 10.1016/j.arthro.2023.10.030.
Chronic retracted rotator cuff tears are difficult entities to treat. L-shaped tears are a particular subset of such rotator cuff tears that pose challenges for surgeons attempting to reduce the supraspinatus tendon back to the greater tuberosity. Lack of full coverage of the tuberosity, need for medialization of the tendon, undue tension, and incomplete reconstitution of the rotator cable are some of the reasons L-shaped retracted tears of the supraspinatus can be challenging. Anterior cable reconstruction (ACR) is a technique that has gained increasing recent popularity, as is the use of patch augmentation. The long head of the biceps tendon is often readily available for use in ACR, but when it isn't, patch augmentation is an option for partially repairable rotator cuff tears. These produce similar postoperative improvements in range of motion as well as Constant and American Shoulder and Elbow Surgeons scores, but comparison to partial repair is still unknown.
慢性回缩性肩袖撕裂是难以治疗的病症。L形撕裂是此类肩袖撕裂的一个特殊子集,对于试图将冈上肌腱复位到大结节的外科医生来说是一项挑战。大结节缺乏完全覆盖、肌腱需要内移、过度张力以及肩袖缆线的不完全重建是冈上肌L形回缩性撕裂具有挑战性的一些原因。前缆线重建(ACR)是一种近来越来越受欢迎的技术,补片增强术的应用也是如此。肱二头肌长头肌腱通常很容易用于ACR,但如果无法使用,则补片增强术是部分可修复肩袖撕裂的一种选择。这些方法在术后活动范围以及Constant评分和美国肩肘外科医生协会评分方面产生了类似的改善,但与部分修复的比较仍不明确。