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关节镜下经骨修复治疗肩袖撕裂患者的临床及影像学结果回顾性评估

Retrospective Evaluation of Clinical and Radiological Results of Patients Treated With Arthroscopic Transosseous Repair for Rotator Cuff Tear.

作者信息

Aydın Mustafa, Fırat Ahmet

机构信息

Orthopedics and Traumatology, Gülhane Training and Research Hospital, Ankara, TUR.

Orthopedics and Traumatology, Etlik City Hospital, Ankara, TUR.

出版信息

Cureus. 2024 Oct 7;16(10):e71004. doi: 10.7759/cureus.71004. eCollection 2024 Oct.

DOI:10.7759/cureus.71004
PMID:39507138
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11539916/
Abstract

BACKGROUND

Surgical repair is recommended for symptomatic full-thickness rotator cuff tears to restore muscle function and alleviate pain. Advances in arthroscopic techniques and new implant designs have led to more reliable repair methods. The choice of technique is crucial for achieving favorable clinical outcomes.

OBJECTIVES

This study evaluates the short-term clinical and radiological outcomes of patients treated with the arthroscopic transosseous technique (ATO).

METHODS

Data from 43 patients who underwent full-thickness rotator cuff (RC) repair using the arthroscopic transosseous technique between February 2014 and April 2016 were prospectively collected and retrospectively reviewed. Included patients had medium-sized (1-3 cm) full-thickness supraspinatus tears extending to the infraspinatus and underwent tenotomy or biceps tenodesis. Functional outcomes were assessed using the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and constant score at their final follow-up appointment.

RESULT

Radiological evaluation included postoperative MRI to assess re-tear development. The mean follow-up period was 26.52±8.14 months. Postoperative VAS, ASES, and constant scores significantly improved compared to preoperative values (3.14±1.20, 88.4±8.12, and 88.9±10.6, respectively).

CONCLUSION

The ATO technique provides strong mechanical and biological repair, yielding good functional outcomes for full-thickness rotator cuff tears (RCTs). It is an effective method for early recovery of shoulder joint range of motion (ROM) and pain reduction.

摘要

背景

对于有症状的全层肩袖撕裂,建议进行手术修复以恢复肌肉功能并减轻疼痛。关节镜技术的进步和新的植入物设计带来了更可靠的修复方法。技术的选择对于获得良好的临床结果至关重要。

目的

本研究评估关节镜下经骨技术(ATO)治疗患者的短期临床和放射学结果。

方法

前瞻性收集并回顾性分析了2014年2月至2016年4月间43例行关节镜下经骨技术全层肩袖(RC)修复患者的数据。纳入患者为中型(1-3厘米)全层冈上肌撕裂并延伸至冈下肌,且接受了肌腱切断术或肱二头肌肌腱固定术。在最后一次随访时,使用视觉模拟量表(VAS)、美国肩肘外科医师学会(ASES)评分和常数评分评估功能结果。

结果

放射学评估包括术后MRI以评估再撕裂的发生情况。平均随访期为26.52±8.14个月。与术前值相比,术后VAS、ASES和常数评分显著改善(分别为3.14±1.20、88.4±8.12和88.9±10.6)。

结论

ATO技术提供了强大的机械和生物修复,对于全层肩袖撕裂(RCT)产生了良好的功能结果。它是早期恢复肩关节活动范围(ROM)和减轻疼痛的有效方法。

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本文引用的文献

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Long-term results after arthroscopic transosseous rotator cuff repair.关节镜下经骨缝合修复肩袖撕裂的长期疗效。
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Longitudinal Long-term Magnetic Resonance Imaging and Clinical Follow-up After Single-Row Arthroscopic Rotator Cuff Repair: Clinical Superiority of Structural Tendon Integrity.单排关节镜下肩袖修补术后的纵向长期磁共振成像及临床随访:结构肌腱完整性的临床优势
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Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair.
肩袖完整性与开放式修复后至少 16 年的临床和功能结果相关。
Clin Orthop Relat Res. 2013 Feb;471(2):554-61. doi: 10.1007/s11999-012-2494-1. Epub 2012 Aug 16.
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Comparative evaluation of the tendon-bone interface contact pressure in different single- versus double-row suture anchor repair techniques.不同单排与双排缝线锚钉修复技术的腱骨界面接触压力的比较评估。
Knee Surg Sports Traumatol Arthrosc. 2009 Dec;17(12):1466-72. doi: 10.1007/s00167-009-0771-7. Epub 2009 Mar 21.
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Suture anchor fixation strength in osteopenic versus non-osteopenic bone for rotator cuff repair.用于肩袖修复的骨质疏松性骨与非骨质疏松性骨中缝线锚钉固定强度的比较
Arch Orthop Trauma Surg. 2009 Mar;129(3):373-9. doi: 10.1007/s00402-008-0689-4. Epub 2008 Jul 8.
6
Part I: Footprint contact characteristics for a transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique.第一部分:与双排修复技术相比,一种经骨等效肩袖修复技术的足迹接触特征。
J Shoulder Elbow Surg. 2007 Jul-Aug;16(4):461-8. doi: 10.1016/j.jse.2006.09.010. Epub 2007 Feb 22.
7
Part II: Biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique.第二部分:与双排修复技术相比,用于恢复足迹的经骨等效肩袖修复技术的生物力学评估。
J Shoulder Elbow Surg. 2007 Jul-Aug;16(4):469-76. doi: 10.1016/j.jse.2006.09.011. Epub 2007 Feb 22.
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[Arthroscopic repair of full-thickness cuff tears: a multicentric retrospective study of 576 cases with anatomical assessment].[关节镜下全层肩袖撕裂修复术:576例解剖学评估的多中心回顾性研究]
Rev Chir Orthop Reparatrice Appar Mot. 2005 Dec;91(S8):31-42. doi: 10.1016/s0035-1040(05)84503-9.
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Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation.关节镜下全层肩袖修复术后的功能和结构结果:单排与双排固定
Arthroscopy. 2005 Nov;21(11):1307-16. doi: 10.1016/j.arthro.2005.08.011.