Guizzi Alberto, Collin Philippe, Zbinden Jeanni, Hurtado Juan Arturo, Amiri Arash, Lädermann Alexandre
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
CHP Saint-Gregoire, Saint-Grégoire, France.
Arthrosc Tech. 2024 Feb 3;13(4):102919. doi: 10.1016/j.eats.2024.102919. eCollection 2024 Apr.
Dealing with massive and irreparable rotator cuff tears presents intricate challenges. Concerning elder patients, either conservative management or reverse shoulder arthroplasty could be the most appropriate treatment. On the other hand, in younger patients, there is a wide spectrum of solutions, most of them being under evaluation and not completely validated. The complexity increases when a greater tuberosity avulsion occurs at the same time. Regardless of whether surgical fixation is performed, there is a risk for bone resorption, which would result in the posterosuperior cuff's insertion spot loss. In this case, the surgeon is expected to simultaneously manage the bone loss and the tendon tear. The Calcaneum-Achilles Tendon Allograft (CalATA) therefore appears to play an interesting role due to its solid bone-tendon structure. This Technical Note aims to present the CalATA technique, which consists in both tendon and bone deficiency restoration in massive rotator cuff tears with greater tuberosity resorption.
处理巨大且无法修复的肩袖撕裂存在复杂的挑战。对于老年患者，保守治疗或反肩关节置换术可能是最合适的治疗方法。另一方面，对于年轻患者，有多种解决方案，其中大多数仍在评估中且未完全得到验证。当同时发生大结节撕脱时，复杂性会增加。无论是否进行手术固定，都存在骨吸收的风险，这将导致肩袖后上部分的附着点丧失。在这种情况下，外科医生需要同时处理骨量丢失和肌腱撕裂问题。因此，跟腱 - 跟骨同种异体移植物（CalATA）因其坚实的骨 - 腱结构而似乎发挥着有趣的作用。本技术说明旨在介绍CalATA技术，该技术包括在伴有大结节吸收的巨大肩袖撕裂中同时修复肌腱和骨缺损。
