Ünlü Gökhan, Çatma Mehmet Faruk, Satılmış Ahmet Burak, Cengiz Tolgahan, Ünlü Serhan, Erdem Mustafa, Ersan Önder
Department of Orthopedics and Traumatology, Medicalpark Gebze Hospital, 41400 Kocaeli, Turkey.
Department of Orthopedics and Traumatology, Etlik City Hospital, 06010 Ankara, Turkey.
Medicina (Kaunas). 2025 Apr 6;61(4):674. doi: 10.3390/medicina61040674.
: Shoulder pain, mainly involving rotator cuff tears, is a common type of musculoskeletal pain that significantly impairs quality of life. Arthroscopic rotator cuff repair has become the gold standard for treating symptomatic, full-thickness rotator cuff tears. Double-row repair techniques are widely used because of their superior fixation and healing results. However, fewer implants may reduce treatment costs and raise questions about the impact on clinical outcomes and re-tear rates. This study compares the functional outcomes and re-tear rates of two transosseous-like double-row repair techniques: one anchor and one push lock (Group 1), and two anchors and two push locks (Group 2). : A prospective, randomized, single-blind study was conducted on 53 patients undergoing arthroscopic repair for crescent-shaped rotator cuff tears (3-5 cm). Before surgery and 24 months after surgery, patients were evaluated for shoulder function using Constant-Murley scores and shoulder abduction angles. MRI was used to assess re-tear rates. : Both groups showed significant postoperative improvement in Constant scores (Group 1: 84.1; Group 2: 84.0; > 0.05). Re-tear rates were slightly higher in Group 1 (23.1%) than in Group 2 (18.5%), but this was not statistically significant ( > 0.05). Shoulder abduction angles improved similarly between groups, with no significant difference in outcome. Despite higher costs and longer operative times, the two-anchor technique provided more stable fixation, but its functional outcomes were comparable to the single-anchor method. : Using fewer implants in a double-row repair provides comparable functional outcomes and re-tear rates, and offers surgeons a cost-effective alternative, especially at the beginning of their learning curve. However, the two-anchor technique may be more beneficial in cases requiring improved mechanical stability. These findings provide valuable information to balance cost and effectiveness in rotator cuff repair.
肩部疼痛，主要涉及肩袖撕裂，是一种常见的肌肉骨骼疼痛类型，会严重影响生活质量。关节镜下肩袖修复已成为治疗有症状的全层肩袖撕裂的金标准。双排修复技术因其卓越的固定和愈合效果而被广泛应用。然而，减少植入物数量可能会降低治疗成本，并引发对其对临床结果和再撕裂率影响的质疑。本研究比较了两种类似经骨双排修复技术的功能结果和再撕裂率：一个锚钉和一个推锁（第1组），以及两个锚钉和两个推锁（第2组）。
对53例接受关节镜修复新月形肩袖撕裂（3 - 5厘米）的患者进行了一项前瞻性、随机、单盲研究。在手术前和手术后24个月，使用Constant-Murley评分和肩部外展角度对患者的肩部功能进行评估。使用MRI评估再撕裂率。
两组患者术后Constant评分均有显著改善（第1组：84.1；第2组：84.0；P>0.05）。第1组的再撕裂率（23.1%）略高于第2组（18.5%），但差异无统计学意义（P>0.05）。两组间肩部外展角度改善情况相似，结果无显著差异。尽管双锚钉技术成本更高、手术时间更长，但提供了更稳定的固定，但其功能结果与单锚钉方法相当。
在双排修复中使用较少的植入物可提供相当的功能结果和再撕裂率，并为外科医生提供了一种经济有效的选择，尤其是在他们学习曲线的初期。然而，在需要改善机械稳定性的情况下，双锚钉技术可能更有益。这些发现为平衡肩袖修复中的成本和有效性提供了有价值的信息。
