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两种关节镜技术治疗部分关节面肩袖撕裂六年随访的比较临床评估

Comparative Clinical Evaluation of Two Techniques in the Arthroscopic Treatment of Partial Articular Rotator Cuff Tears after Six Years of Follow-up.

作者信息

Sella Guilherme do Val, Silva Luciana Andrade da, Okamoto Ricardo Makoto, Marmille Hector Carmona, do Val Pedro Gabriel Pelegrino, Miyazaki Alberto Naoki

机构信息

Grupo de Cirurgia de Ombro, Departamento de Ortopedia e Traumatologia, Faculdade de Ciências Médicas, Santa Casa de São Paulo, Pavilhão Fernandinho Simonsen, São Paulo, SP, Brasil.

出版信息

Rev Bras Ortop (Sao Paulo). 2024 Dec 7;59(5):e771-e778. doi: 10.1055/s-0044-1790211. eCollection 2024 Oct.

Abstract

To clinically evaluate the medium-term results of the arthroscopic treatment of partial-thickness rotator cuff tears (PTRCT) using the transtendon repair (TTR) technique and the tear completion repair (TCR) technique through the modified University of California, Los Angeles (UCLA) Shoulder Rating Scale, the Constant-Murley score, and force analysis.  The present was a retrospective reevaluation study of cases operated on arthroscopically for PTRCT after a minimum follow-up of 6 years. There were 34 patients, 18 of whom underwent TTR and 16, TCR. We compared the current UCLA and Constant-Murley scores, the mean strength between the techniques, and the UCLA score currently and 2 years after surgery for the same group, as published in a previous study, to assess whether or not the results changed throughout time.  There was no statistical difference regarding the scores. The current UCLA scores were of 33.8 for the TTR and of 32.9 for the TCR (  = 0.113), and the current Constant-Murley scores were of 91.9 and 86.8 respectively (  = 0.075). For the TTR, the previous UCLA score was (2 years postoperatively) of 32.4 and the current score was of 33.8 (  = 0.374); for the TCR, the score after 2 years was of 32.4, and the current score was of 32.9 (  = 0.859). In the TTR, the mean strength was statistically higher on the dominant side (11 kg) than on the non-dominant side (7.80 kg) (  = 0.023) and those of the TCR (8.25 kg) (  = 0.042).  There was no statistical difference in the medium term when comparing the UCLA and Constant-Murley scores concerning the technique used (TTR or TCR), nor was there any change in UCLA scores between 2 and 6 years postoperatively. Among the patients submitted to TTR, the mean strength was statistically higher on the dominant side than on the non-dominant side, and higher than that of the patients submitted to TCR.

摘要

为了通过改良的加州大学洛杉矶分校(UCLA)肩关节评分量表、Constant-Murley评分以及力量分析,从临床角度评估采用经肌腱修复(TTR)技术和撕裂完成修复(TCR)技术治疗部分厚度肩袖撕裂(PTRCT)的中期结果。本研究是一项回顾性重新评估研究,对接受关节镜手术治疗PTRCT且随访至少6年的病例进行分析。共有34例患者,其中18例接受TTR治疗,16例接受TCR治疗。我们比较了当前的UCLA和Constant-Murley评分、两种技术之间的平均力量,以及同一组患者目前和手术2年后的UCLA评分(如先前研究中所发表),以评估结果是否随时间变化。评分方面无统计学差异。TTR组当前的UCLA评分为33.8,TCR组为32.9(P = 0.113),当前的Constant-Murley评分分别为91.9和86.8(P = 0.075)。对于TTR组,先前(术后2年)的UCLA评分为32.4,当前评分为33.8(P = 0.374);对于TCR组,2年后的评分为32.4,当前评分为32.9(P = 0.859)。在TTR组中,优势侧的平均力量在统计学上高于非优势侧(11千克)(P = 0.023),也高于TCR组(8.25千克)(P = 0.042)。在比较采用TTR或TCR技术时,UCLA和Constant-Murley评分在中期无统计学差异,术后2至6年UCLA评分也无变化。在接受TTR治疗的患者中,优势侧的平均力量在统计学上高于非优势侧,且高于接受TCR治疗的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af6c/11624924/fd93c55a66c4/10-1055-s-0044-1790211-i2400094en-1.jpg

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