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青年与老年患者不可修复性肩袖前上撕裂的背阔肌联合大圆肌腱转位术临床疗效比较

Comparison of clinical outcomes of anterior combined latissimus dorsi and teres major tendon transfer for anterior superior irreparable rotator cuff tear between young and elderly patients.

作者信息

Baek Chang Hee, Kim Bo Taek, Kim Jung Gon, Kim Seung Jin

机构信息

Department of Orthopedic Surgery, Yeosu Baek Hospital, Yeosu, Korea.

出版信息

Clin Shoulder Elb. 2024 Sep;27(3):327-337. doi: 10.5397/cise.2024.00248. Epub 2024 Aug 6.

DOI:10.5397/cise.2024.00248
PMID:39138942
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11393437/
Abstract

BACKGROUND

Anterior combined latissimus dorsi and teres major (aLDTM) tendon transfer has shown promise as a treatment for anterior superior irreparable rotator cuff tears (ASIRCTs). Our study aimed to compare aLDTM clinical outcomes for ASIRCTs between young and elderly patients.

METHODS

This retrospective study reviewed data from patients who underwent aLDTM tendon transfer for ASIRCTs with minimum 2-year follow-up. Clinical evaluations included visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), active range of motion (aROM), strength, and complications. Radiologic assessments included acromiohumeral distance, Hamada classification, and integrity of transferred tendon. Patients were divided into group total (all ages), group old (≥70 years), and group young (≤60 years).

RESULTS

A total of 123 patients were enrolled with 39 in group young (mean age, 56.6±4.9 years) and 27 in group old (mean age, 73.6±2.3 years). Postoperatively, both groups showed significant improvements in VAS, ASES, and SANE scores and improved aROM for forward elevation, abduction, and internal rotation. No significant differences in clinical coutcomes were noted between the groups. Furthermore, similar rates of complications, including retears and postoperative infections, were observed across all three groups.

CONCLUSIONS

Our study highlights the effectiveness of aLDTM transfer for ASIRCTs with minimal glenohumeral arthritis, demonstrating similar outcomes in both group young and group old patients. Moreover, patients in these distinct age groups showed comparable clinical results when compared to group total. Level of evidence: III.

摘要

背景

背阔肌和大圆肌联合前入路肌腱转移术(aLDTM)已显示出有望用于治疗不可修复的肩袖前上撕裂(ASIRCT)。我们的研究旨在比较年轻和老年患者ASIRCT的aLDTM临床疗效。

方法

这项回顾性研究回顾了接受aLDTM肌腱转移术治疗ASIRCT且随访至少2年的患者的数据。临床评估包括视觉模拟量表(VAS)、美国肩肘外科医师学会(ASES)评分、单项评估数字评定法(SANE)、主动活动范围(aROM)、力量和并发症。影像学评估包括肩峰下间隙、滨田分类和转移肌腱的完整性。患者分为总体组(所有年龄)、老年组(≥70岁)和年轻组(≤60岁)。

结果

共纳入123例患者,年轻组39例(平均年龄56.6±4.9岁),老年组27例(平均年龄73.6±2.3岁)。术后,两组的VAS、ASES和SANE评分均显著改善,前屈、外展和内旋的aROM也有所改善。两组之间的临床疗效无显著差异。此外,在所有三组中观察到的并发症发生率相似,包括再撕裂和术后感染。

结论

我们的研究强调了aLDTM转移术治疗合并轻度盂肱关节炎的ASIRCT的有效性,表明年轻组和老年组患者的疗效相似。此外,与总体组相比,这些不同年龄组的患者临床结果相当。证据级别:III级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/04fcd4f3851f/cise-2024-00248f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/3f21e85b8c6c/cise-2024-00248f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/12c1d899a9fe/cise-2024-00248f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/ee2fb1a22503/cise-2024-00248f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/04fcd4f3851f/cise-2024-00248f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/3f21e85b8c6c/cise-2024-00248f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/12c1d899a9fe/cise-2024-00248f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/ee2fb1a22503/cise-2024-00248f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850a/11393437/04fcd4f3851f/cise-2024-00248f4.jpg

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