Mihata Teruhisa
Department of Orthopedic Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Katsuragi Hospital, Kishiwada, Osaka, Japan.
JSES Int. 2024 Feb 13;8(3):667-672. doi: 10.1016/j.jseint.2024.01.012. eCollection 2024 May.
Arthroscopic superior capsule reconstruction (SCR) was developed to restore superior shoulder stability, muscle balance, and function after irreparable posterior-superior rotator cuff tears. The purpose of this study was to investigate whether favorable clinical outcomes after SCR for irreparable rotator cuff tears would be obtained in patients aged more than 70 years.
A total of 173 consecutive shoulders in 162 patients who underwent arthroscopic SCR using autografts of fascia lata for irreparable rotator cuff tears were allocated to 3 groups according to patient age at the time of surgery: Group 1, <55 years old (11 shoulders); Group 2, 55-70 years old (85 shoulders); and Group 3, > 70 years old (77 shoulders). American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores, active shoulder range of motion, and visual analog scale were evaluated before surgery and at the final follow-up. Postoperative complications, including graft tears in magnetic resonance imaging and donor-site morbidity, were assessed.
The mean follow-up was 3 years and 9 months. Both American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores and active range of motion (elevation, external rotation, and internal rotation) increased significantly after arthroscopic SCR in all 3 groups ( < .001), and visual analog scale decreased significantly. All 3 groups had low graft tear (6%-10%) and donor site morbidity (0%-1%) rates, with no significant difference among the groups.
Arthroscopic SCR can lead to functional improvement and pain relief with a low rate of complications regardless of patient age.
关节镜下上盂唇重建术(SCR)旨在修复不可修复的肩后上盂唇撕裂后的肩关节稳定性、肌肉平衡和功能。本研究的目的是调查年龄超过70岁的患者在接受SCR治疗不可修复的肩袖撕裂后是否能获得良好的临床效果。
162例患者共173个肩关节接受了关节镜下SCR,使用自体阔筋膜移植修复不可修复的肩袖撕裂,根据手术时患者年龄分为3组:第1组,年龄<55岁(11个肩关节);第2组,年龄55-70岁(85个肩关节);第3组,年龄>70岁(77个肩关节)。在手术前和末次随访时评估美国肩肘外科医师协会(ASES)评分、日本骨科协会(JOA)评分、肩关节活动度以及视觉模拟评分(VAS)。评估术后并发症,包括磁共振成像(MRI)检查中的移植组织撕裂和供区并发症。
平均随访时间为3年9个月。在所有3组中,关节镜下SCR术后ASES评分、JOA评分以及主动活动范围(前屈、外旋和内旋)均显著增加(P<0.001),VAS评分显著降低。所有3组的移植组织撕裂率(6%-10%)和供区并发症发生率(0%-1%)均较低,组间差异无统计学意义。
无论患者年龄如何,关节镜下SCR均可改善功能、缓解疼痛,且并发症发生率较低。