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用于促进肩袖撕裂愈合的缝线带锚钉:一项回顾性队列研究。

Suture tape anchors for enhancing healing in rotator cuff tears: a retrospective cohort study.

作者信息

Nie Shixin, Qin Hao, Tan Hao, Zhao Pei, Yan Wenlong, Zhou Aiguo, Zhang Jian, Lian Chengjie, Zhang Hua

机构信息

Department of Orthopaedics, Sports Injury Division, Fujian Medical University Union Hospital, Fuzhou, 350001, China.

Department of Orthopedics, Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Musculoskelet Disord. 2025 May 13;26(1):470. doi: 10.1186/s12891-025-08728-3.

Abstract

BACKGROUND

Rotator cuff injuries are common, particularly among older adults, and are often treated with arthroscopic repair. However, retear rates remain high. This study compares clinical and structural outcomes between arthroscopic double-row suture bridge repairs using either suture tape anchors (STAs) with knotless medial fixation, or traditional knotted suture anchors (TSAs) with knotted medial fixation.

METHODS

This retrospective cohort study compared arthroscopic double-row suture bridge repairs performed from January 2021 to July 2023 using either knotless STAs or knotted TSAs. Eligible patients had medium (1-3 cm), large (3-5 cm), or massive (> 5 cm) full-thickness rotator cuff tears (DeOrio-Cofield classification) with no greater than Goutallier grade 3 fatty infiltration. Clinical outcomes were measured using VAS, Constant, UCLA, and ASES scores, both preoperatively and at 1-year postoperative follow-up. Muscle strength was assessed using manual muscle testing (0-5 scale) with the arm positioned at 30° scapular elevation. Structural outcomes were evaluated via MRI, where two trained surgeons assessed tendon thickness using the Sugaya classification and identified retears according to the Cho classification. Statistical analysis was conducted using SPSS.

RESULTS

The study included 86 consecutive patients undergoing arthroscopic rotator cuff repair, with 36 patients in the STA group (median follow-up 15.0 months, range 12-19 months) and 50 patients in the traditional suture anchor (TSA) group (median follow-up 16.5 months, range 12-20 months). Both groups showed significant improvements in functional scores (VAS, Constant, UCLA, ASES) postoperatively (P < 0.05), with no significant differences between the two groups (P > 0.05). The STAs group had significantly lower tendon thinning and higher tendon thickness and supraspinatus muscle strength compared to the TSAs group (P < 0.05). The retear rate was similar between the two groups (12.0% for TSAs and 11.1% for STAs, P > 0.05).

CONCLUSIONS

At 1 year, both STAs and TSAs showed favorable clinical outcomes, but STAs were more effective in preserving tendon thickness and improving muscle strength. Although retear rates were similar, STAs may offer advantages in tendon healing and functional recovery.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

肩袖损伤很常见,尤其是在老年人中,并且通常采用关节镜修复治疗。然而,再撕裂率仍然很高。本研究比较了使用无结内侧固定的缝线带锚钉(STA)或使用有结内侧固定的传统有结缝线锚钉(TSA)进行关节镜双排缝线桥修复后的临床和结构结果。

方法

这项回顾性队列研究比较了2021年1月至2023年7月期间使用无结STA或有结TSA进行的关节镜双排缝线桥修复。符合条件的患者患有中度(1 - 3厘米)、大型(3 - 5厘米)或巨大型(>5厘米)全层肩袖撕裂(DeOrio - Cofield分类),脂肪浸润不超过Goutallier 3级。在术前和术后1年随访时,使用视觉模拟评分法(VAS)、Constant评分、加州大学洛杉矶分校(UCLA)评分和美国肩肘外科医师协会(ASES)评分来测量临床结果。使用徒手肌力测试(0 - 5级)在肩胛骨抬高30°时评估肌肉力量。通过磁共振成像(MRI)评估结构结果,由两名经过培训的外科医生使用Sugaya分类评估肌腱厚度,并根据Cho分类识别再撕裂情况。使用SPSS进行统计分析。

结果

该研究纳入了86例连续接受关节镜肩袖修复的患者,其中STA组36例(中位随访15.0个月,范围12 - 19个月),传统缝线锚钉(TSA)组50例(中位随访16.5个月,范围12 - 20个月)。两组术后功能评分(VAS、Constant、UCLA、ASES)均有显著改善(P < 0.05),两组之间无显著差异(P > 0.05)。与TSA组相比,STA组的肌腱变薄程度明显更低,肌腱厚度和冈上肌力量更高(P < 0.05)。两组的再撕裂率相似(TSA组为12.0%,STA组为11.1%,P > 0.05)。

结论

在1年时,STA和TSA均显示出良好的临床结果,但STA在保留肌腱厚度和改善肌肉力量方面更有效。尽管再撕裂率相似,但STA在肌腱愈合和功能恢复方面可能具有优势。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52a6/12070591/e3c19d6c5bce/12891_2025_8728_Fig1_HTML.jpg

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