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减轻关节镜下肩袖修复并发症的策略。

Strategies to mitigate complications in arthroscopic rotator cuff repair.

作者信息

Fierro Guido, Romero Gabriela Gómez, Lievano Jorge Rojas, Lacouture Juan David, González Juan Carlos

机构信息

Fundación Santa Fe de Bogotá, Bogotá, Colombia, Calle 119 #7-75.

Universidad de Los Andes, Bogotá, Colombia, Carrera 1 #18-12.

出版信息

J Clin Orthop Trauma. 2024 Dec 5;60:102852. doi: 10.1016/j.jcot.2024.102852. eCollection 2025 Jan.

Abstract

The rotator cuff, a vital group of tendons and muscles in the shoulder, is essential for stabilizing the joint and enabling a wide range of arm movements. Rotator cuff tears, common across all age groups, often cause significant pain and functional limitations. Rotator cuff repair surgery aims to alleviate pain, restore function, and improve quality of life. Recent advances, particularly in arthroscopic techniques, have enhanced surgical outcomes and shortened recovery times. Nevertheless, risks remain, including surgical site infections, tendon retears, stiffness, severe postoperative pain, and nerve injuries. This article explores the complexities of rotator cuff repair, dividing complications into intraoperative and postoperative categories. Key challenges in arthroscopic techniques include ensuring optimal visualization, preventing anchor pullout, and managing chondral damage. Postoperative concerns such as infections, stiffness, and retears are also discussed, with an emphasis on preoperative skin preparation and emerging interventions like benzoyl peroxide application and platelet-rich plasma. By incorporating surgical innovations, evidence-based protocols, and comprehensive patient management, clinicians can enhance outcomes and recovery rates. The ongoing exploration of new treatments and collaborative research efforts are crucial for refining treatment protocols and advancing orthopedic patient care.

摘要

肩袖是肩部一组重要的肌腱和肌肉,对于稳定关节和实现手臂的广泛运动至关重要。肩袖撕裂在所有年龄组中都很常见,常导致严重疼痛和功能受限。肩袖修复手术旨在减轻疼痛、恢复功能并改善生活质量。最近的进展,特别是在关节镜技术方面,提高了手术效果并缩短了恢复时间。然而,风险仍然存在,包括手术部位感染、肌腱再次撕裂、僵硬、严重的术后疼痛和神经损伤。本文探讨了肩袖修复的复杂性,将并发症分为术中及术后两类。关节镜技术的关键挑战包括确保最佳视野、防止锚钉拔出以及处理软骨损伤。还讨论了术后的问题,如感染、僵硬和再次撕裂,重点是术前皮肤准备以及新出现的干预措施,如应用过氧化苯甲酰和富血小板血浆。通过纳入手术创新、循证方案和全面的患者管理,临床医生可以提高手术效果和恢复率。对新治疗方法的不断探索以及合作研究努力对于完善治疗方案和推进骨科患者护理至关重要。

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Strategies to mitigate complications in arthroscopic rotator cuff repair.减轻关节镜下肩袖修复并发症的策略。
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