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使用脱细胞真皮同种异体移植物并辅以肱二头肌改道进行关节镜下上盂唇重建治疗不可修复的肩袖撕裂:“帐篷搭建”技术

Arthroscopic Superior Capsule Reconstruction Using an Acellular Dermal Allograft Augmented With Biceps Rerouting for Irreparable Rotator Cuff Tear: "Tent-Pitching" Technique.

作者信息

Wang Po-Yao, Wu Jia-Lin

机构信息

Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan.

Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

出版信息

Arthrosc Tech. 2025 Feb 11;14(6):103467. doi: 10.1016/j.eats.2025.103467. eCollection 2025 Jun.

DOI:10.1016/j.eats.2025.103467
PMID:40656721
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12255393/
Abstract

Superior capsular reconstruction is a surgical technique for the treatment of massive irreparable rotator cuff tears. Different types of grafts have been used. Human dermal allograft has the advantage of avoiding autograft harvest-site morbidity but may elongate with graft loading, resulting in eventual superior humeral head migration. The purpose of this Technical Note is to describe an arthroscopic technique using the long head of the biceps tendon rerouting in superior capsular reconstruction with nonirradiated human acellular dermis for irreparable rotator cuff tears.

摘要

肩袖上重建术是一种治疗巨大不可修复性肩袖撕裂的外科技术。已使用了不同类型的移植物。人同种异体真皮移植物具有避免自体移植物供区并发症的优点,但可能会因移植物负荷而延长,导致最终肱骨头向上移位。本技术说明的目的是描述一种关节镜技术,即在肩袖上重建术中使用肱二头肌长头肌腱改道,并结合未辐照的人脱细胞真皮来治疗不可修复性肩袖撕裂。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/435726df8334/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/a7903972ed4f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/15872e4f42d2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/89d2c4e90e92/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/a6a4bf53c90e/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/833a76623630/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/0f2a2be78c49/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/435726df8334/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/a7903972ed4f/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/15872e4f42d2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/89d2c4e90e92/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/a6a4bf53c90e/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/833a76623630/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/0f2a2be78c49/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24ff/12255393/435726df8334/gr7.jpg

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本文引用的文献

1
Biceps Rerouting Regardless of a Biceps-Labral Lesion During Rotator Cuff Repair Results in Lower Retear Rates and Comparable Clinical Outcomes to Subpectoral Biceps Tenodesis.在进行肩袖修复时,无论二头肌-盂唇复合体病变如何,行二头肌转位术可降低再撕裂率,并获得与胸小肌下肌腱固定术相当的临床效果。
Arthroscopy. 2024 Aug;40(8):2162-2170. doi: 10.1016/j.arthro.2024.01.024. Epub 2024 Feb 3.
2
Mid-Term Outcome of Superior Capsular Reconstruction Using Fascia Lata Autograft (At Least 6 mm in Thickness) Results in High Retear Rate and No Improvement in Muscle Strength.阔筋膜移植物(厚度至少 6 毫米)重建肩袖上盂唇的中期结果显示高再撕裂率且肌肉力量无改善。
Arthroscopy. 2024 Jul;40(7):1961-1971. doi: 10.1016/j.arthro.2024.01.020. Epub 2024 Feb 3.
3
No Difference In Clinical Outcomes Following Repair of Large Retracted Anterior Rotator Cuff Tears Using Patch Augmentation With Human Dermal Allograft Versus Anterior Cable Reconstruction With Biceps Tendon Autograft.使用人真皮异体移植物修补大回缩性肩袖前撕裂与使用肱二头肌腱自体移植物行前侧缆重建修复后临床结果无差异。
Arthroscopy. 2024 Feb;40(2):294-302. doi: 10.1016/j.arthro.2023.08.077. Epub 2023 Sep 15.
4
Arthroscopic Superior Capsular Reconstruction With the Long Head of the Biceps Tendon to Reinforce the Repair of a Supraspinatus Tear and Increase Healing.关节镜下使用肱二头肌长头进行上盂唇重建以加强冈上肌撕裂的修复并促进愈合。
Arthrosc Tech. 2023 Jul 31;12(8):e1457-e1465. doi: 10.1016/j.eats.2023.04.017. eCollection 2023 Aug.
5
Irreparable Rotator Cuff Tear Treated With Combined Reconstruction of the Superior Capsule and Rotator Cuff: Technique Guidelines.采用上盂唇和肩袖联合重建治疗不可修复性肩袖撕裂:技术指南
Arthrosc Tech. 2023 May 29;12(6):e965-e973. doi: 10.1016/j.eats.2023.02.034. eCollection 2023 Jun.
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Arthroscopy. 2024 Jan;40(1):47-54. doi: 10.1016/j.arthro.2023.06.014. Epub 2023 Jun 22.
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Arthroscopy. 2022 Jan;38(1):38-48. doi: 10.1016/j.arthro.2021.05.064. Epub 2021 Jun 12.
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Clinical Outcomes of Superior Capsular Reconstruction for Massive, Irreparable Rotator Cuff Tears: A Systematic Review Comparing Acellular Dermal Allograft and Autograft Fascia Lata.巨大不可修复性肩袖撕裂上盂唇重建的临床结果:比较脱细胞真皮同种异体移植物和自体阔筋膜的系统评价
Arthrosc Sports Med Rehabil. 2020 Dec 27;3(1):e257-e268. doi: 10.1016/j.asmr.2020.09.002. eCollection 2021 Feb.
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Superior Capsular Reconstruction With Double Bundle of Long Head Biceps Tendon Autograft: The "Box" Technique.双束肱二头肌长头肌腱自体移植上盂唇重建:“盒式”技术
Arthrosc Tech. 2020 Nov 20;9(11):e1747-e1757. doi: 10.1016/j.eats.2020.07.017. eCollection 2020 Nov.
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Arthrosc Tech. 2020 Oct 27;9(11):e1683-e1688. doi: 10.1016/j.eats.2020.07.011. eCollection 2020 Nov.