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经单排锚钉技术与经骨无锚钉技术行关节镜下肩袖修补术的疗效:一项随机对照试验。

Outcomes of arthroscopic rotator cuff repair via single-row anchor technique versus transosseous anchorless technique: A randomized controlled trial.

作者信息

Mesriga Mustafa Mohamed, Mesregah Mohamed Kamal, Dewidar Ahmed Abdel-Monem, Saad Hany Elsayed, Ebied Ayman Mohamed

机构信息

Department of Orthopaedic Surgery, Menoufia University Faculty of Medicine, Menoufia, Shebin-El-Kom, Egypt.

出版信息

J Clin Orthop Trauma. 2025 Feb 18;64:102951. doi: 10.1016/j.jcot.2025.102951. eCollection 2025 May.

Abstract

BACKGROUND

Rotator cuff tears can be addressed using various repair techniques. This study sought to compare the clinical and radiologic outcomes and costs after arthroscopic single-row anchor repair and arthroscopic transosseous repair for small to medium-sized tears.

METHODS

The study was a prospective randomized clinical trial (registered as trial number PACTR202404475835971 in the Pan African Clinical Trial Registry, Apr 04, 2024) that included 62 patients, randomized into two equal groups. Group A: single-row anchor repair (n = 31) and Group B: transosseous repair (n = 31). Patients were clinically evaluated using the American Shoulder and Elbow Surgeons (ASES) score and Oxford Shoulder Score (OSS), in addition to evaluation of range of motion (ROM) of forward flexion, external rotation (ER), and internal rotation (IR). Total implant costs were calculated and compared.

RESULTS

In both groups, the ROM increased significantly, P < 0.001. The mean differences between preoperative and postoperative forward flexion, ER, and IR were comparable in both groups, P = 0.933, 0.817, and 0.151, respectively. The mean ASES score and OSS improved significantly in both groups at last follow-up, P < 0.001. The mean follow-up ASES score was 91.1 ± 3.5 in Group A and 90.8 ± 2.7 in Group B, P = 0.818. The mean follow-up OSS was 42.4 ± 2.1 in Group A and 41.5 ± 1.9 in Group B, P = 0.214. The average financial cost of operation was significantly lesser in the transosseous group than the anchors group, P < 0.001.

CONCLUSION

Anchorless transosseous rotator cuff repair can achieve similar excellent functional outcomes as the single-row anchor repair, with equivalent tendon healing results. However, the transosseous technique has substantially lower costs.

摘要

背景

肩袖撕裂可采用多种修复技术进行治疗。本研究旨在比较关节镜下单排锚钉修复和关节镜下经骨修复治疗中小型肩袖撕裂后的临床和影像学结果及成本。

方法

本研究为一项前瞻性随机临床试验(于2024年4月4日在泛非临床试验注册中心注册,注册号为PACTR202404475835971),纳入62例患者,随机分为两组。A组:单排锚钉修复(n = 31);B组:经骨修复(n = 31)。除评估前屈、外旋(ER)和内旋(IR)的活动范围(ROM)外,还采用美国肩肘外科医师(ASES)评分和牛津肩评分(OSS)对患者进行临床评估。计算并比较总植入成本。

结果

两组患者的ROM均显著增加,P < 0.001。两组术前与术后前屈、ER和IR的平均差异相当,P分别为0.933、0.817和0.151。末次随访时,两组患者的平均ASES评分和OSS均显著改善,P < 0.001。A组末次随访时的平均ASES评分为91.1 ± 3.5,B组为90.8 ± 2.7,P = 0.818。A组末次随访时的平均OSS为42.4 ± 2.1,B组为41.5 ± 1.9,P = 0.214。经骨修复组的平均手术费用显著低于锚钉修复组,P < 0.001。

结论

无锚钉经骨肩袖修复术可获得与单排锚钉修复术相似的优异功能结果,肌腱愈合效果相当。然而,经骨修复技术的成本显著更低。

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J Shoulder Elbow Surg. 2019 Apr;28(4):706-714. doi: 10.1016/j.jse.2018.09.003. Epub 2018 Dec 17.
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Arthroscopic trans-osseous rotator cuff repair.关节镜下经骨的肩袖修复术。
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