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关节镜与小切口肩袖修复术后临床疗效和修复完整性的比较:一项观察性研究。

Comparison of clinical outcomes and repair integrity after arthroscopic versus mini-open rotator cuff repair: An observational study.

机构信息

Department of Orthopedics and Traumatology, Celal Bayar University Faculty of Medicine, Manisa, Turkey.

出版信息

Medicine (Baltimore). 2024 May 31;103(22):e38181. doi: 10.1097/MD.0000000000038181.

Abstract

This study aimed to evaluate the differences between mini-open (MO) and arthroscopic (ART) repair procedures for rotator cuff tendon tears in terms of clinical and radiological outcomes. This retrospective study included 59 patients, and data were collected prospectively. Patients with full-thickness rotator cuff tears were randomized to undergo MO or ART repair at 2 centers by 2 surgeons between January 2012 and December 2017. Data were collected 3 weeks before surgery and 6 and 12 months after surgery. Physical function was assessed using the American Shoulder and Elbow Surgeons index, VAS, and Constant scoring system. Radiological outcomes were assessed using the Sugaya classification, adapted for ultrasound. Changes between baseline and follow-up were compared between the 2 groups. Fifty-nine patients who underwent ART or MO rotator cuff repair were included in this study. The 2 groups had similar demographic characteristics and preoperative baseline parameters. Both the MO and ART groups showed statistically significant improvement in outcome parameters (P ≤ .0001); however, cuff repair integrity was significantly better in the ART group (P = .023). All other improvements in the patient-derived parameters were equivalent. None of the patients in either group required revision surgery. According to the results of our retrospective study, MO and ART rotator cuff repair are effective and viable options for surgeons to repair rotator cuff tears. There were no differences in objective and subjective outcomes between the full ART and MO techniques for rotator cuff tears. Surgeons should choose a technique with which they are more familiar.

摘要

本研究旨在评估肩袖肌腱撕裂的微创(MO)和关节镜(ART)修复手术在临床和影像学结果方面的差异。这是一项回顾性研究,纳入了 59 例患者,数据是前瞻性收集的。所有全层肩袖撕裂患者由 2 位外科医生在 2 家中心通过随机分配接受 MO 或 ART 修复。数据在术前 3 周和术后 6 个月、12 个月采集。通过美国肩肘外科医生评分、视觉模拟评分(VAS)和Constant 评分系统评估上肢功能。采用超声改良的 Sugaya 分类评估影像学结果。比较两组间基线和随访时的变化。本研究共纳入 59 例行 ART 或 MO 肩袖修复的患者。两组患者的人口统计学特征和术前基线参数相似。MO 和 ART 组的所有结果参数均有统计学意义的改善(P ≤.0001);然而,ART 组的肩袖修复完整性显著更好(P = .023)。患者衍生参数的所有其他改善均相当。两组均无患者需要翻修手术。根据我们的回顾性研究结果,MO 和 ART 肩袖修复是治疗肩袖撕裂的有效且可行的选择。对于肩袖撕裂,ART 全关节镜和 MO 技术在客观和主观结果方面没有差异。外科医生应选择他们更熟悉的技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67b3/11142816/def453253135/medi-103-e38181-g001.jpg

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