PDF(Pubmed)
Abstract：
OBJECTIVE: The optimal repair method for bursal-side partial-thickness rotator cuff tears (PTRCTs) involving >50% of the thickness remains a controversial topic. The study was aimed to compare the functional and magnetic resonance imaging (MRI) outcomes after in situ repair or tear completion before repair of bursal-side PTRCTs.
METHODS: A retrospective clinical study was conducted involving 58 patients who underwent in situ repair or tear completion before repair of bursal-side PTRCTs between January 2019 and December 2020. These patients were divided into two groups: the in situ repair group and the tear completion before repair group. Functional assessment consisted of active range of motion (ROM), visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score. The percentages of patients in each group achieving the minimal clinical important difference (MCID) of the functional scores were determined. The healing status of the rotator cuff was assessed by postoperative MRI.
RESULTS: There were no statistically significant differences between the two groups in terms of demographic data. The mean follow-up period was 14.53 ± 2.64 months in the in situ repair group and 15.40 ± 2.66 months in the tear completion before repair group. At the final follow-up, the forward elevation, external rotation, and internal rotation improved significantly in both groups. The VAS, ASES score, and Constant-Murley score improved significantly in the in situ repair group (5.17 ± 2.00 points to 0.11 ± 0.41 points, p = 0.001; 44.04 ± 17.40 points to 95.47 ± 4.32 points, p = 0.001; 49.50 ± 14.38 points to 93.50 ± 3.49 points, p = 0.001) and in the tear completion before repair group (5.43 ± 3.32 points to 0.03 ± 0.18 points, p = 0.001; 41.50 ± 19.59 points to 95.94 ± 2.68 points, p = 0.001; 47.54 ± 17.13 points to 93.97 ± 2.61 points, p = 0.001). Postoperative MRI revealed that the re-tear rate was 7.1% (2/28) in the in situ repair group and 3.3% (1/30) in the tear completion before repair group. No significant differences were observed in terms of the functional scores, the percentages of patients achieving the MCID of the functional scores, and the re-tear rate between the two groups (p > 0.05).
CONCLUSIONS: Both in situ repair and tear completion before repair yielded satisfactory clinical outcomes for patients with bursal-side PTRCTs. No significant differences were observed in the functional and MRI outcomes between the two groups.
METHODS: A retrospective clinical study was conducted involving 58 patients who underwent in situ repair or tear completion before repair of bursal-side PTRCTs between January 2019 and December 2020. These patients were divided into two groups: the in situ repair group and the tear completion before repair group. Functional assessment consisted of active range of motion (ROM), visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score. The percentages of patients in each group achieving the minimal clinical important difference (MCID) of the functional scores were determined. The healing status of the rotator cuff was assessed by postoperative MRI.
RESULTS: There were no statistically significant differences between the two groups in terms of demographic data. The mean follow-up period was 14.53 ± 2.64 months in the in situ repair group and 15.40 ± 2.66 months in the tear completion before repair group. At the final follow-up, the forward elevation, external rotation, and internal rotation improved significantly in both groups. The VAS, ASES score, and Constant-Murley score improved significantly in the in situ repair group (5.17 ± 2.00 points to 0.11 ± 0.41 points, p = 0.001; 44.04 ± 17.40 points to 95.47 ± 4.32 points, p = 0.001; 49.50 ± 14.38 points to 93.50 ± 3.49 points, p = 0.001) and in the tear completion before repair group (5.43 ± 3.32 points to 0.03 ± 0.18 points, p = 0.001; 41.50 ± 19.59 points to 95.94 ± 2.68 points, p = 0.001; 47.54 ± 17.13 points to 93.97 ± 2.61 points, p = 0.001). Postoperative MRI revealed that the re-tear rate was 7.1% (2/28) in the in situ repair group and 3.3% (1/30) in the tear completion before repair group. No significant differences were observed in terms of the functional scores, the percentages of patients achieving the MCID of the functional scores, and the re-tear rate between the two groups (p > 0.05).
CONCLUSIONS: Both in situ repair and tear completion before repair yielded satisfactory clinical outcomes for patients with bursal-side PTRCTs. No significant differences were observed in the functional and MRI outcomes between the two groups.
摘要：
目的：涉及>50％厚度的法氏囊侧部分厚度肩袖撕裂（PTRCT）的最佳修复方法仍然是一个有争议的话题。该研究旨在比较原位修复后的功能和磁共振成像（MRI）结果或在法氏囊侧PTRCT修复前的撕裂完成。
方法：进行了一项回顾性临床研究，涉及2019年1月至2020年12月期间在法氏囊侧PTRCT修复前进行了原位修复或撕裂完成的58例患者。将这些患者分为两组：原位修复组和撕裂完成前修复组。功能评估包括活动范围（ROM），视觉模拟量表(VAS)，美国肩肘外科医师（ASES）评分，和Constant-Murley得分.确定每组中达到功能评分的最小临床重要差异（MCID）的患者百分比。通过术后MRI评估肩袖的愈合状态。
结果：在人口统计学数据方面，两组之间没有统计学上的显着差异。原位修复组平均随访时间为14.53±2.64个月，修复前撕裂完成时间为15.40±2.66个月。在最后的后续行动中，向前的高度,外部旋转,两组内旋明显改善。VAS,ASES得分,原位修复组Constant-Murley评分明显改善(5.17±2.00分至0.11±0.41分,p=0.001；44.04±17.40分至95.47±4.32分，p=0.001；49.50±14.38分至93.50±3.49分，p=0.001）和修复前撕裂完成组（5.43±3.32分至0.03±0.18分，p=0.001；41.50±19.59分至95.94±2.68分，p=0.001；47.54±17.13分至93.97±2.61分，p=0.001)。术后MRI显示，原位修复组的再撕裂率为7.1％（2/28），修复前的再撕裂率为3.3％（1/30）。在功能评分方面没有观察到显著差异，达到功能评分MCID的患者百分比，两组之间的再撕裂率（p>0.05）。
结论：对于法氏囊侧PTRCT患者，原位修复和修复前完成撕裂均取得了令人满意的临床结果。两组在功能和MRI结果上没有观察到显著差异。
方法：进行了一项回顾性临床研究，涉及2019年1月至2020年12月期间在法氏囊侧PTRCT修复前进行了原位修复或撕裂完成的58例患者。将这些患者分为两组：原位修复组和撕裂完成前修复组。功能评估包括活动范围（ROM），视觉模拟量表(VAS)，美国肩肘外科医师（ASES）评分，和Constant-Murley得分.确定每组中达到功能评分的最小临床重要差异（MCID）的患者百分比。通过术后MRI评估肩袖的愈合状态。
结果：在人口统计学数据方面，两组之间没有统计学上的显着差异。原位修复组平均随访时间为14.53±2.64个月，修复前撕裂完成时间为15.40±2.66个月。在最后的后续行动中，向前的高度,外部旋转,两组内旋明显改善。VAS,ASES得分,原位修复组Constant-Murley评分明显改善(5.17±2.00分至0.11±0.41分,p=0.001；44.04±17.40分至95.47±4.32分，p=0.001；49.50±14.38分至93.50±3.49分，p=0.001）和修复前撕裂完成组（5.43±3.32分至0.03±0.18分，p=0.001；41.50±19.59分至95.94±2.68分，p=0.001；47.54±17.13分至93.97±2.61分，p=0.001)。术后MRI显示，原位修复组的再撕裂率为7.1％（2/28），修复前的再撕裂率为3.3％（1/30）。在功能评分方面没有观察到显著差异，达到功能评分MCID的患者百分比，两组之间的再撕裂率（p>0.05）。
结论：对于法氏囊侧PTRCT患者，原位修复和修复前完成撕裂均取得了令人满意的临床结果。两组在功能和MRI结果上没有观察到显著差异。
