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关节镜下双排肩袖修补术伴或不伴肱二头肌长头腱转位的临床比较

Clinical comparison of arthroscopic double-row rotator cuff repair with or without long head of biceps tendon transposition.

作者信息

Zhou Yu-Jun, Wang Bei-Bei, Wen Hua-Wei, Xu Liang, Feng Jing, Xu Fu-Sheng

机构信息

Department of Trauma Center, Wuhan No. 1 Hospital, Wuhan 430022, Hubei Province, China.

Department of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan 430065, Hubei Province, China.

出版信息

World J Orthop. 2025 Jun 18;16(6):103875. doi: 10.5312/wjo.v16.i6.103875.

Abstract

BACKGROUND

Long head of biceps tendon (LHBT) transposition is a novel technique based on the double-row suture bridge method, utilizing autologous reconstruction to treat massive rotator cuff tears.

AIM

To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.

METHODS

This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021. The patients were divided into the double-row repair group (conventional group) and the double-row repair combined with the LHBT transposition group (transposition group). Postoperative pain was assessed using the visual analogue scale at one week, one year, and the final follow-up. Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up. Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification, which categorizes tendon integrity based on magnetic resonance imaging findings.

RESULTS

No perioperative complications were observed in any of the patients at any time. There were no significant differences between the groups regarding operative time and intraoperative blood loss. The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively; however, there were no significant differences between the groups at one year or the final follow-up. At one year postoperatively, the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group; no significant differences were observed at the final follow-up. There were no significant differences in rotator cuff healing between the groups at one year postoperatively.

CONCLUSION

Compared to double-row repair alone, double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.

摘要

背景

肱二头肌长头肌腱(LHBT)转位是一种基于双排缝合桥接方法的新技术,利用自体重建治疗巨大肩袖撕裂。

目的

评估双排修复方法治疗巨大肩袖撕裂的中长期临床疗效。

方法

本回顾性分析纳入了2020年至2021年在我院接受治疗的53例巨大肩袖撕裂患者的数据。患者分为双排修复组(传统组)和双排修复联合LHBT转位组(转位组)。术后1周、1年及末次随访时使用视觉模拟量表评估术后疼痛。术后1年及末次随访时使用美国肩肘外科医师学会(ASES)和Constant-Murley评分评估肩关节功能。术后1年使用Sugaya分类评估肩袖愈合情况,该分类根据磁共振成像结果对肌腱完整性进行分类。

结果

所有患者在任何时间均未观察到围手术期并发症。两组在手术时间和术中出血量方面无显著差异。转位组术后1周的视觉模拟量表评分显著低于传统组;然而,在1年或末次随访时两组之间无显著差异。术后1年,转位组的ASES和Constant-Murley评分显著高于传统组;末次随访时未观察到显著差异。术后1年两组肩袖愈合情况无显著差异。

结论

与单纯双排修复相比,双排修复联合LHBT转位治疗巨大肩袖撕裂能更有效地减轻术后短期疼痛,并在第一年改善肩关节功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22ff/12179892/a6026f9c7c1c/wjo-16-6-103875-g001.jpg

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