Huang Peiguan, Wang Xiaoxu, Fu Yong, Tang Xiaojun, Xiao Zhihong, Li Zhengmao, Peng Bin, He Min, He Chunrong
Second Affiliated Hospital, Department of Joint Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, China.
Arthrosc Tech. 2024 Jun 8;13(10):103068. doi: 10.1016/j.eats.2024.103068. eCollection 2024 Oct.
Transtendon repair is increasingly applied in the treatment of PASTA (partial articular supraspinatus tendon avulsion) lesions, but a "tendon hole" from anchor insertion, which will break the intact bursal layer and potentially result in tear completion, is an unavoidable problem. The "mini-incision" transtendon double-pulley suture bridge presented in the study is a pragmatic technique in treatment of PASTA lesion. The 4 suture strands on the medial-row anchor provide enough biomechanical strength on the reattached articular layer, the "mini-incision" minimizes iatrogenic trauma on the bursal layer, and double-pulley suture-bridge smoothly covers the "mini-incision" so as to achieve anatomical reduction of articular and bursa side of supraspinatus tendon. The surgical technique is described, as well as pearls, pitfalls, advantages, and disadvantages.
经肌腱修复术在PASTA(部分关节面冈上肌腱撕脱)损伤的治疗中应用越来越广泛,但锚钉植入造成的“肌腱孔”会破坏完整的滑囊层并可能导致撕裂完全形成,这是一个不可避免的问题。本研究中提出的“小切口”经肌腱双滑轮缝合桥是治疗PASTA损伤的一种实用技术。内侧排锚钉上的4根缝线在重新附着的关节层上提供了足够的生物力学强度,“小切口”将滑囊层的医源性创伤降至最低,双滑轮缝合桥可顺利覆盖“小切口”,从而实现冈上肌腱关节侧和滑囊侧的解剖复位。文中描述了手术技术以及要点、陷阱、优点和缺点。