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关节镜下自体阔筋膜移植修复不可修复的后上肩袖撕裂的上囊重建术

Arthroscopic Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears with Autologous Fascia Lata Graft.

作者信息

Cheng You-Hung, Chen Poyu, Chen Chung-Yu, Yang Cheng-Pang, Hsu Chen-Heng, Chen Alvin Chao-Yu, Chiu Joe Chih-Hao

机构信息

Department of Orthopedic Surgery, New Taipei Municipal Tu-Cheng Hospital, Chang Gung Memorial Hospital; Comprehensive Sports Medicine Center, Linkou Chang Gung Memorial Hospital.

Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University; Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital.

出版信息

J Vis Exp. 2025 Jun 6(220). doi: 10.3791/68064.

DOI:10.3791/68064
PMID:40549673
Abstract

This study explores the efficacy of superior capsule reconstruction (SCR) using fascia lata autograft for treating irreparable rotator cuff tears. Based on our experience and existing literature, SCR has demonstrated promising outcomes, offering improved shoulder stability, reduced pain, and prevention of humeral head migration. Patients undergoing SCR with fascia lata autograft achieved near-normal shoulder range of motion postoperatively, with maintained acromio-humeral distance observed in radiographic follow-ups. Various graft modifications, including the use of dermal grafts and the long head of the biceps tendon, have been explored. Yet, studies indicate the superior thickness and tensile strength of fascia lata autograft supports more durable outcomes. The SCR protocol detailed in this study includes meticulous graft harvesting, arthroscopic examination, and precise graft placement with suture anchors to ensure stability. Postoperative care involves immobilization followed by gradual rehabilitation, promoting effective healing and functional recovery. This approach highlights SCR's potential as a valuable treatment for active patients with irreparable rotator cuff tears.

摘要

本研究探讨使用自体阔筋膜进行上盂唇重建(SCR)治疗不可修复的肩袖撕裂的疗效。根据我们的经验和现有文献,SCR已显示出有前景的结果,可改善肩部稳定性、减轻疼痛并防止肱骨头移位。接受自体阔筋膜SCR的患者术后实现了接近正常的肩部活动范围,影像学随访观察到肩峰下间隙保持稳定。已探索了各种移植物改良方法,包括使用真皮移植物和肱二头肌长头肌腱。然而,研究表明自体阔筋膜移植物的厚度和拉伸强度更优,可支持更持久的疗效。本研究中详细描述的SCR方案包括细致的移植物获取、关节镜检查以及使用缝合锚钉精确放置移植物以确保稳定性。术后护理包括固定,随后逐步进行康复,促进有效愈合和功能恢复。这种方法凸显了SCR作为治疗不可修复肩袖撕裂的活跃患者的一种有价值治疗方法的潜力。

相似文献

1
Arthroscopic Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears with Autologous Fascia Lata Graft.关节镜下自体阔筋膜移植修复不可修复的后上肩袖撕裂的上囊重建术
J Vis Exp. 2025 Jun 6(220). doi: 10.3791/68064.
2
Combined Superior Capsular Reconstruction Using Fascia Lata Autograft and Lower Trapezius Transfer Using Achilles Tendon Allograft Are Associated With Improved Surgical Outcomes in Patients With Chronic Posterosuperior Irreparable Massive Rotator Cuff Tears.采用阔筋膜自体移植的联合上盂唇重建术和使用跟腱同种异体移植的下斜方肌转移术与慢性后上不可修复的巨大肩袖撕裂患者手术效果改善相关。
Arthroscopy. 2025 Jul;41(7):2248-2258. doi: 10.1016/j.arthro.2024.11.096. Epub 2024 Dec 11.
3
Long-term Clinical and Structural Outcomes of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears: 10-Year Follow-up.关节镜下上盂唇重建治疗不可修复性肩袖撕裂的长期临床和结构转归:10年随访
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Graft Utilization in the Bridging Reconstruction of Irreparable Rotator Cuff Tears: A Systematic Review.不可修复性肩袖撕裂桥接重建中移植物的应用:一项系统评价
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Superior capsular reconstruction after failed rotator cuff repair using a fascia lata autograft is associated with inferior outcomes compared to primary superior capsular reconstruction for irreparable massive rotator cuff tears.与针对不可修复的巨大肩袖撕裂进行一期上盂唇重建相比,使用阔筋膜自体移植修复失败后进行上盂唇重建的效果较差。
Int Orthop. 2025 Jun 18. doi: 10.1007/s00264-025-06568-3.
6
Arthroscopic Superior Capsule Reconstruction With Combined Fascia Lata Autograft Augmented With Either LARS Ligament or Polypropylene Mesh Synthetic Scaffold Patch Graft: A Comparison of Techniques With a Minimum 2-Year Follow-up for the Treatment of Irreparable Rotator Cuff Tears.关节镜下采用阔筋膜自体移植联合LARS韧带或聚丙烯网片合成支架补片增强进行上盂唇重建:治疗不可修复性肩袖撕裂的技术比较及至少2年随访
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7
Postoperative graft integrity affects clinical outcomes after superior capsule reconstruction using fascia lata autograft in posterior-superior rotator cuff tears: a multicenter study.阔筋膜移植物重建肩袖后上盂唇复合体撕裂术后移植物完整性影响临床结局:一项多中心研究。
J Shoulder Elbow Surg. 2023 Jul;32(7):1476-1485. doi: 10.1016/j.jse.2022.12.010. Epub 2023 Jan 18.
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Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes.使用肱二头肌长头肌腱进行肩关节上盂唇重建:手术技术与临床结果的系统评价
Medicina (Kaunas). 2021 Mar 2;57(3):229. doi: 10.3390/medicina57030229.
9
Better functional outcomes and a lower infection rate can be expected after superior capsular reconstruction in comparison with latissimus dorsi tendon transfer for massive, irreparable posterosuperior rotator cuff tears: a systematic review.与背阔肌腱转位术相比,对于巨大不可修复的肩袖后上撕裂,采用上方囊重建术可获得更好的功能结果和更低的感染率:系统评价。
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10
Arthroscopic Superior Capsule Reconstruction Can Eliminate Pseudoparalysis in Patients With Irreparable Rotator Cuff Tears.关节镜上囊重建术可消除不可修复肩袖撕裂患者的假性瘫痪。
Am J Sports Med. 2018 Sep;46(11):2707-2716. doi: 10.1177/0363546518786489. Epub 2018 Aug 6.