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关节镜下使用阔筋膜修补不可修复的肩袖撕裂

Arthroscopic Patch Bridging Using Fascia Lata for Irreparable Rotator Cuff Tears.

作者信息

Sun Youqiang, Chen Jianfa, Wang Yuanyuan, Xiang Xiaobing

机构信息

Department of Sports Medicine, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Arthrosc Tech. 2024 Jun 27;14(2):103000. doi: 10.1016/j.eats.2024.103000. eCollection 2025 Feb.

DOI:10.1016/j.eats.2024.103000
PMID:40041316
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11873483/
Abstract

We describe an arthroscopic technique for irreparable rotator cuff tears using patch bridging reconstruction with fascia lata autograft. Compared with conventional rotator cuff repair, this technique reconstitutes the rotator cuff as a dynamic structure, preserves the rotator cuff remnant, reduces excessive tension of the rotator cuff, and preserves the shoulder joint. The fascia lata patch itself is low cost and avoids risks of transmission of blood-borne infectious diseases and rejection. Although the bridging reconstruction is a complex operation with a long learning curve, we believe patch bridging using fascia lata is a highly effective and reproducible surgical protocol for appropriate irreparable rotator cuff tear patients.

摘要

我们描述了一种使用阔筋膜自体移植片桥接重建术治疗不可修复性肩袖撕裂的关节镜技术。与传统的肩袖修复术相比，该技术将肩袖重建为一个动态结构，保留肩袖残余组织，减少肩袖的过度张力，并保留肩关节。阔筋膜移植片本身成本低，可避免血源性传染病传播和排斥反应的风险。尽管桥接重建是一项操作复杂、学习曲线较长的手术，但我们认为，对于合适的不可修复性肩袖撕裂患者，使用阔筋膜进行移植片桥接是一种高效且可重复的手术方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/9f9dbec549ae/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/f6122866027b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/6ca1e427717a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/e784682dd2f4/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/7a5e3a0fd820/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/42a0e0fdc631/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/26b08dc6bbdd/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/3eb6dd929345/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/9f9dbec549ae/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/f6122866027b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/6ca1e427717a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/e784682dd2f4/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/7a5e3a0fd820/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/42a0e0fdc631/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/26b08dc6bbdd/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/3eb6dd929345/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/744f/11873483/9f9dbec549ae/gr8.jpg

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本文引用的文献

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Rotator Cuff Repair With Patch Augmentation Is Associated With Lower Retear Rates for Large Tears: A Systematic Review of Randomized Controlled Trials.带补片增强的肩袖修补术与大撕裂的低再撕裂率相关：一项随机对照试验的系统评价。
Arthroscopy. 2024 Apr;40(4):1300-1308. doi: 10.1016/j.arthro.2023.08.072. Epub 2023 Sep 19.
2
Midterm outcomes of autologous bridging of rotator cuff tears with an autologous tendon patch (TEAR patch).采用自体肌腱补片（TEAR补片）自体桥接修复肩袖撕裂的中期疗效
J Shoulder Elbow Surg. 2024 Feb;33(2):312-320. doi: 10.1016/j.jse.2023.06.024. Epub 2023 Jul 22.
3
Management of the Irreparable Rotator Cuff Tear.
不可修复性肩袖撕裂的处理。
J Am Acad Orthop Surg. 2019 Dec 15;27(24):909-917. doi: 10.5435/JAAOS-D-18-00199.
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Treatment Strategy for Irreparable Rotator Cuff Tears.不可修复性肩袖撕裂的治疗策略
Clin Orthop Surg. 2018 Jun;10(2):119-134. doi: 10.4055/cios.2018.10.2.119. Epub 2018 May 18.
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Partial repair in irreparable rotator cuff tear: our experience in long-term follow-up.不可修复性肩袖撕裂的部分修复：我们的长期随访经验
Acta Biomed. 2017 Oct 18;88(4S):69-74. doi: 10.23750/abm.v88i4-S.6796.
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Arthroscopic Partial Repair of Irreparable Rotator Cuff Tears: Factors Related to Greater Degree of Clinical Improvement at 2 Years of Follow-Up.关节镜下不可修复性肩袖撕裂的部分修复：与 2 年随访时临床改善程度更大相关的因素。
Arthroscopy. 2017 Nov;33(11):1949-1955. doi: 10.1016/j.arthro.2017.06.047. Epub 2017 Aug 31.
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Graft Utilization in the Bridging Reconstruction of Irreparable Rotator Cuff Tears: A Systematic Review.不可修复性肩袖撕裂桥接重建中移植物的应用：一项系统评价
Am J Sports Med. 2017 Nov;45(13):3149-3157. doi: 10.1177/0363546517694355. Epub 2017 Mar 27.
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Outcomes After Patch Use in Rotator Cuff Repair.肩袖修补术中使用补片后的结果。
Arthroscopy. 2016 Aug;32(8):1676-90. doi: 10.1016/j.arthro.2016.02.009. Epub 2016 May 4.
9
Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review.关节镜下修复慢性巨大肩袖撕裂：一项系统评价
Arthroscopy. 2015 Dec;31(12):2472-80. doi: 10.1016/j.arthro.2015.06.038. Epub 2015 Sep 11.
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Massive Irreparable Rotator Cuff Tears: A Solution That Bridges the Gap.巨大不可修复性肩袖撕裂：一种弥合差距的解决方案。
Sports Med Arthrosc Rev. 2015 Sep;23(3):130-8. doi: 10.1097/JSA.0000000000000064.