El Safoury Yasser, Sabry Ahmed O
Department of Orthopedics and Traumatology, KasrAlAinyFacultyofMedicine, Cairo University, Al- Manial, Cairo, Egypt.
Sci Rep. 2025 Jan 17;15(1):2333. doi: 10.1038/s41598-025-85520-2.
Treatment of Massive rotator cuff tears (MRCT) is difficult, with high rates of retears. Using biological augmentation in the form of the highly vascular subacromial bursa, was used to improve tendon healing. This work aimed to evaluate the results of arthroscopic guided mini-open transosseous repair with bursal augmentation in the treatment of MRCTs in a five-step approach. Forty-eight patients, with a mean age of 63.15 years, were treated with this technique. The patients were evaluated with the constant, UCLA and VAS scores. Plain X-rays were performed to evaluate the CSA and MRI was done to confirm the diagnosis of MRCT and determine the degree of fatty degeneration. Ultrasound was done at 1 year post-operative to determine any retears. The mean follow-up period was 29 months ± 4.95. The Constant and UCLA mean scores improved from (52.52) to (89) and (13.2) to (30.5) respectively (p < 0.0001). The post-operative active flexion and abduction improved from a mean of (112° to 170°) and (136.2° to 167°) respectively, while ER improved from (62.8° to 70°) with their p values (p < 0.0001). Pain improved from a mean VAS of (5.85) to (0.5) (p < 0.0001). No deterioration of function was noted throughout the follow-up period, and no retears occurred on post-operative ultrasound evaluation. Mini-open transosseous repair with bursal augmentation in the treatment of MRCT is an effective and low-cost method that achieves satisfactory results with no retears.
巨大肩袖撕裂（MRCT）的治疗具有挑战性，再撕裂率很高。利用高度血管化的肩峰下滑囊进行生物增强，以促进肌腱愈合。本研究旨在通过五步关节镜引导下小切口经骨修复联合滑囊增强技术，评估其治疗巨大肩袖撕裂的效果。48例患者接受了该技术治疗，平均年龄63.15岁。采用Constant、UCLA和视觉模拟评分法（VAS）对患者进行评估。通过X线平片评估肩峰下间隙（CSA），并进行磁共振成像（MRI）以确诊巨大肩袖撕裂并确定脂肪变性程度。术后1年行超声检查以确定有无再撕裂。平均随访时间为29个月±4.95个月。Constant和UCLA平均评分分别从（52.52）提高到（89），从（13.2）提高到（30.5）（p<0.0001）。术后主动屈曲和外展平均角度分别从（112°提高到170°）和（136.2°提高到167°），而外旋从（62.8°提高到70°），p值均<0.0001。疼痛VAS评分从平均（5.85）降至（0.5）（p<0.0001）。随访期间功能无恶化，术后超声检查未发现再撕裂。关节镜引导下小切口经骨修复联合滑囊增强技术治疗巨大肩袖撕裂是一种有效且低成本的方法，可取得满意效果且无再撕裂发生。
