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不可修复性肩袖撕裂的治疗进展

Advancements in the Management of Irreparable Rotator Cuff Tears.

作者信息

Jeon In-Ho, Kholinne Erica

机构信息

Department of Orthopedic Surgery, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, South Korea.

Faculty of Medicine, Universitas Trisakti, Gatam Institute, Eka Hospital, Jakarta, Indonesia.

出版信息

Indian J Orthop. 2025 Jan 14;59(6):731-742. doi: 10.1007/s43465-024-01322-0. eCollection 2025 Jun.

DOI:10.1007/s43465-024-01322-0
PMID:40511355
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12151978/
Abstract

BACKGROUND

Rotator cuff tears (RTC) are a common cause of shoulder pain in adults, with massive and irreparable tears presenting significant treatment challenges. Addressing these tears effectively is crucial for improving patient outcomes. To review recent advancements in the surgical management of irreparable rotator cuff tears.

METHODS

This review examines both non-surgical and surgical approaches for managing irreparable RTCs. Non-surgical treatments, such as physical therapy, are considered for less severe tears, while surgical options are categorized into nonprosthetic and prosthetic procedures, with an emphasis on recent advancements.

RESULTS

Surgical interventions for irreparable rotator cuff tears (RTC) include non-prosthetic procedures such as debridement, partial repair, marginal convergence, tendon transfer, interposition graft, subacromial balloon spacer, and superior capsular reconstruction. Additionally, prosthetic surgery options include reverse total shoulder arthroplasty. Recent innovations in surgical techniques and technologies have enhanced treatment outcomes, allowing for more personalized approaches to managing irreparable RTC. These advancements have improved both functional recovery and patient satisfaction.

CONCLUSION

The management of massive and irreparable RTCs requires a personalized treatment strategy, considering patient-specific factors and the latest surgical advancements. Ongoing research is needed to refine these interventions and improve long-term results for patients with this challenging condition.

摘要

背景

肩袖撕裂(RTC)是成人肩部疼痛的常见原因,巨大且无法修复的撕裂带来了重大的治疗挑战。有效处理这些撕裂对于改善患者预后至关重要。回顾无法修复的肩袖撕裂手术治疗的最新进展。

方法

本综述探讨了处理无法修复的RTC的非手术和手术方法。对于不太严重的撕裂,考虑采用物理治疗等非手术治疗方法,而手术选择分为非假体和假体手术,重点关注最新进展。

结果

无法修复的肩袖撕裂(RTC)的手术干预包括非假体手术,如清创术、部分修复、边缘融合、肌腱转移、间置移植、肩峰下气囊间隔器和上盂唇重建。此外,假体手术选择包括反式全肩关节置换术。手术技术和技术的最新创新提高了治疗效果,使处理无法修复的RTC有了更个性化的方法。这些进展改善了功能恢复和患者满意度。

结论

对于巨大且无法修复的RTC的管理需要个性化的治疗策略,考虑患者特定因素和最新的手术进展。需要持续研究以完善这些干预措施,并改善患有这种具有挑战性疾病的患者的长期结果。