Department of Sports Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
Institute of Sports Medicine and Osteoarthropathy of Hangzhou Medical College, Hangzhou, Zhejiang, China.
BMC Musculoskelet Disord. 2024 Jul 5;25(1):519. doi: 10.1186/s12891-024-07634-4.
At present, shoulder arthroscopy is usually used for treatment of rotator cuff injuries. There is still debate over the precise technique of using shoulder arthroscopy to treat partial articular-sided supraspinatus tendon injuries.
To compare the clinical efficacy of the arthroscopic transtendon repair method and the arthroscopic full-thickness repair method in the treatment of patients with Ellman III partial articular-sided supraspinatus tendon tears and to analyze the influencing factors of postoperative efficacy.
Cohort study; level of evidence,4.
A total of 84 partial-thickness rotator cuff tear (PTRCT) patients with Ellman III injuries who underwent surgical treatment in our hospital between January 2017 and January 2020 were selected and divided into the arthroscopic trans-tenon repair group (32 cases) and the arthroscopic full-thickness repair group (52 cases). Shoulder joint pain and functional status were assessed by the Constant score, ASES score and VAS score; shoulder mobility was assessed by measuring shoulder ROM. The clinical outcomes of the two groups of patients were compared, and the factors affecting the postoperative efficacy of the patients were investigated.
All patients were followed up for at least 2 years. The Constant score, ASES score, and VAS score of the two groups of patients were all improved compared with those before surgery, and the differences were statistically significant (P < 0.05). There were no significant differences in the Constant score, ASES score, or VAS score between the two groups (P > 0.05). The results of binary logistic regression analysis showed that the preoperative ASES score and whether biceps tenotomy was performed were independent risk factors for satisfactory postoperative efficacy (P < 0.05).
For patients with Ellman III partial articular-sided supraspinatus tendon tears, the arthroscopic transtendon repair method and the arthroscopic full-thickness repair method can both significantly improve the shoulder pain and function of the patient, but there is no significant difference between the efficacy of the two surgical methods. The preoperative ASES score and whether biceps tenotomy was performed were independent risk factors for satisfactory postoperative efficacy in PTRCT patients with Ellman III injury.
目前，肩关节镜通常用于治疗肩袖损伤。但对于使用肩关节镜治疗部分关节侧肩袖冈上肌腱损伤的精确技术仍存在争议。
比较关节镜下经腱修复与关节镜下全层修复治疗 Ellman Ⅲ型部分关节侧冈上肌腱撕裂的临床疗效，并分析影响术后疗效的相关因素。
队列研究；证据等级 4 级。
选取 2017 年 1 月至 2020 年 1 月在我院接受手术治疗的 84 例 Ellman Ⅲ型部分肩袖撕裂（PTRCT）患者，根据手术方法分为关节镜下经腱修复组（32 例）和关节镜下全层修复组（52 例）。采用 Constant 评分、ASES 评分和 VAS 评分评估肩关节疼痛和功能状况；采用测量肩关节活动范围评估肩关节活动度。比较两组患者的临床疗效，并分析影响患者术后疗效的相关因素。
所有患者均获得至少 2 年随访。两组患者的 Constant 评分、ASES 评分和 VAS 评分均较术前改善，差异均有统计学意义（P<0.05）。两组患者的 Constant 评分、ASES 评分和 VAS 评分比较，差异均无统计学意义（P>0.05）。二元 logistic 回归分析结果显示，术前 ASES 评分和是否行肱二头肌长头切断术是影响术后疗效满意的独立危险因素（P<0.05）。
对于 Ellman Ⅲ型部分关节侧冈上肌腱撕裂患者，关节镜下经腱修复与关节镜下全层修复均可显著改善患者的肩部疼痛和功能，但两种手术方法的疗效无明显差异。术前 ASES 评分和是否行肱二头肌长头切断术是影响 Ellman Ⅲ型 PTRCT 患者术后疗效满意的独立危险因素。
