Sports and Trauma Pain Institute, 54655, Thessaloniki, Greece.
Medical Center Wuppertal, 42329, Wuppertal, Germany.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):4099-4104. doi: 10.1007/s00590-024-04113-3. Epub 2024 Oct 1.
The aim of this study was to compare the results of single versus double row (TEO) in massive tears of the posterosuperior rotator cuff in patients older than 70 years old.
Between October 2019 and July 2022, 46 patients, older than 70 years old, were operated on, in two centers, by one surgeon (FM), in one center, we performed a single-row repair, while in the other a double row, transosseous equivalent. Patients were paired by age and gender. All patients were studied with a preoperative MRI along with preoperative age and gender adjusted constant score. Postoperative patients were evaluated at the end of the FU. Mean time of FU for single row was 3.2 years (2-4.1) and for TOE was 3.5 years (2.4-3). Mean age for SR patients was 71.15 years (70-82) and for TOE was 74.8 years (70-81). We were able to evaluate 20 pairs of patients (15 pairs of females and five pairs of males).
CS differed in both groups of patients. Patients operated on with TOE had a better, but non-significant CS 81.3 (TOE) versus 75.7 (SR) p > 0.05. The patients operated own with TOE showed statistically significant better arm abduction strength than patients operated on with SR (p < 0.05). There was a trend for patients operated on with TOE to have a better ROM and less pain.
The results of our work show that patients older than 70 years old, with repairable RCT operated on with a transosseous equivalent, have a trend to have a better CS and a significantly better strength than patients operated on with SR.
本研究旨在比较单排(TEO)与双排(TOE)修复 70 岁以上巨大肩袖后上区撕裂的疗效。
2019 年 10 月至 2022 年 7 月,由同一位外科医生(FM)在两个中心对 46 名 70 岁以上的患者进行手术,一个中心采用单排修复,另一个中心采用双排、经骨隧道等长修复。根据年龄和性别对患者进行配对。所有患者均在术前进行 MRI 检查,并进行术前年龄和性别调整后的 Constant 评分。术后患者在随访结束时进行评估。单排组的平均随访时间为 3.2 年(2-4.1 年),TOE 组为 3.5 年(2.4-3 年)。SR 组患者的平均年龄为 71.15 岁(70-82 岁),TOE 组为 74.8 岁(70-81 岁)。我们共评估了 20 对患者(15 对女性和 5 对男性)。
两组患者的 CS 均有差异。采用 TOE 修复的患者 CS 更好,但无统计学意义(TOE 组 81.3 分,SR 组 75.7 分,p>0.05)。TOE 组患者术后的肩外展力量明显优于 SR 组(p<0.05)。TOE 组患者的 ROM 更好,疼痛程度更低,但这些差异无统计学意义。
我们的研究结果表明,对于可修复的 RCT 撕裂,70 岁以上患者采用经骨隧道等长修复技术,其 CS 更好,力量恢复更好,与采用单排修复技术相比有一定优势。