Division of Sports Medicine, NYU Langone Health, New York, New York.
Division of Shoulder and Elbow, Tulane University School of Medicine, New Orleans, Louisiana.
JBJS Rev. 2024 Aug 26;12(8). doi: e24.00063. eCollection 2024 Aug 1.
» Partial-thickness rotator cuff tears (PTRCTs) are a common pathology with a likely high asymptomatic incidence rate, particularly in the overhead athlete.» The anatomy, 5-layer histology, and relationship to Ellman's classification of PTRCTs have been well studied, with recent interest in radiographic predictors such as the critical shoulder angle and acromial index.» Depending on the definition of tear progression, rates of PTRCT progression range from 4% to 44% and appear related to symptomatology and work/activity level.» Nearly all PTRCTs should be managed conservatively initially, particularly in overhead athletes, with those that fail nonoperative management undergoing arthroscopic debridement ± acromioplasty if <50% thickness or arthroscopic conversion repair or in situ repair if >50% thickness.» Augmentation of PTRCTs is promising, with leukocyte-poor platelet-rich plasma having the most robust body of supportive data. Mesenchymal signaling cell biologics and the variety of scaffold onlay augments require more rigorous studies before regular usage.
»部分厚度肩袖撕裂（PTRCT）是一种常见的病理，可能具有较高的无症状发生率，特别是在过顶运动员中。»PTRCT 的解剖结构、5 层组织学和与 Ellman 分类的关系已得到充分研究，最近人们对影像学预测因子（如临界肩角和肩峰指数）产生了兴趣。»根据撕裂进展的定义，PTRCT 进展的发生率在 4%到 44%之间，似乎与症状和工作/活动水平有关。»几乎所有的 PTRCT 都应在初期进行保守治疗，特别是在过顶运动员中，如果撕裂厚度<50%，则行关节镜下清创术±肩峰成形术，如果撕裂厚度>50%，则行关节镜下转换修复或原位修复。»PTRCT 的增强治疗有很大的前景，富含白细胞的富血小板血浆（PRP）具有最有力的支持数据。间充质信号细胞生物制剂和各种支架覆盖物的增强需要更多严格的研究，然后才能常规使用。
