Abstract：
OBJECTIVE: This study aimed to clarify the characteristics of delaminated rotator cuff tears (RCTs) and evaluate the clinical outcomes of a modified arthroscopic en masse suture bridge repair for delaminated RCTs.
METHODS: Patients with full-thickness RCTs, who underwent arthroscopic suture bridge repair with a minimum 2-year follow-up, were retrospectively reviewed. Patients were categorized into two groups based on the presence of delamination. Delaminated RCTs were treated using a modified en masse suture bridge technique, while nondelaminated RCTs received a conventional suture bridge technique. Preoperative and postoperative Constant scores and American Shoulder and Elbow Surgeons (ASES) scores were determined to evaluate clinical outcomes. Postoperative magnetic resonance imaging (MRI) was carried out to identify the integrity and retear of the repaired rotator cuff.
RESULTS: A total of 172 patients were included in our study cohort, in which 67 (39%) delaminated RCTs were confirmed intraoperatively. The prevalence of delamination was significantly higher in large tears (53/102, 52%) compared to medium tears (14/70, 20%) (p < 0.001). No significant differences in age (n.s.) or gender (n.s.) were observed between the two groups. Both groups showed significant improvements in Constant and ASES scores postoperatively (both p < 0.001), with no significant differences between the groups (n.s.). The retear rates were 2/67 (3.0%) in the delamination group and 3/105 (2.9%) in the nondelamination group, showing no significant difference (n.s.).
CONCLUSIONS: The modified arthroscopic en masse suture bridge technique was effective for repairing delaminated RCTs, yielding favourable clinical outcomes comparable to those of nondelaminated tears.
METHODS: Level IV.
METHODS: Patients with full-thickness RCTs, who underwent arthroscopic suture bridge repair with a minimum 2-year follow-up, were retrospectively reviewed. Patients were categorized into two groups based on the presence of delamination. Delaminated RCTs were treated using a modified en masse suture bridge technique, while nondelaminated RCTs received a conventional suture bridge technique. Preoperative and postoperative Constant scores and American Shoulder and Elbow Surgeons (ASES) scores were determined to evaluate clinical outcomes. Postoperative magnetic resonance imaging (MRI) was carried out to identify the integrity and retear of the repaired rotator cuff.
RESULTS: A total of 172 patients were included in our study cohort, in which 67 (39%) delaminated RCTs were confirmed intraoperatively. The prevalence of delamination was significantly higher in large tears (53/102, 52%) compared to medium tears (14/70, 20%) (p < 0.001). No significant differences in age (n.s.) or gender (n.s.) were observed between the two groups. Both groups showed significant improvements in Constant and ASES scores postoperatively (both p < 0.001), with no significant differences between the groups (n.s.). The retear rates were 2/67 (3.0%) in the delamination group and 3/105 (2.9%) in the nondelamination group, showing no significant difference (n.s.).
CONCLUSIONS: The modified arthroscopic en masse suture bridge technique was effective for repairing delaminated RCTs, yielding favourable clinical outcomes comparable to those of nondelaminated tears.
METHODS: Level IV.
摘要：
目的：本研究旨在阐明脱层肩袖撕裂（RCT）的特征，并评估改良关节镜下整体缝合桥修复脱层RCT的临床效果。
方法：全层RCT患者，他们接受了关节镜下缝合桥修复，并进行了至少2年的随访，进行回顾性审查。根据分层的存在将患者分为两组。使用改良的整体缝合桥技术治疗脱层RCT，而未分层的RCT接受了传统的缝合桥技术。确定术前和术后Constant评分以及美国肩肘外科医师（ASES）评分以评估临床结果。进行术后磁共振成像（MRI）以确定修复的肩袖的完整性和再撕裂。
结果：总共172名患者被纳入我们的研究队列，其中67(39%)个脱层RCT在术中得到证实。与中等撕裂(14/70,20%)相比,大撕裂(53/102,52%)中的分层发生率显著更高(p<0.001)。两组之间在年龄（n.s.）和性别（n.s.）方面没有观察到显着差异。两组术后Constant和ASES评分均有显著改善（均p<0.001），组间无显著差异(n.s.)。分层组再撕裂率为2/67(3.0%),非分层组再撕裂率为3/105(2.9%),没有显着差异（n.s.）。
结论：改良的关节镜下集体缝合桥技术可有效修复分层的RCT，产生与未分层的泪液相当的良好临床结局。
方法：四级。
方法：全层RCT患者，他们接受了关节镜下缝合桥修复，并进行了至少2年的随访，进行回顾性审查。根据分层的存在将患者分为两组。使用改良的整体缝合桥技术治疗脱层RCT，而未分层的RCT接受了传统的缝合桥技术。确定术前和术后Constant评分以及美国肩肘外科医师（ASES）评分以评估临床结果。进行术后磁共振成像（MRI）以确定修复的肩袖的完整性和再撕裂。
结果：总共172名患者被纳入我们的研究队列，其中67(39%)个脱层RCT在术中得到证实。与中等撕裂(14/70,20%)相比,大撕裂(53/102,52%)中的分层发生率显著更高(p<0.001)。两组之间在年龄（n.s.）和性别（n.s.）方面没有观察到显着差异。两组术后Constant和ASES评分均有显著改善（均p<0.001），组间无显著差异(n.s.)。分层组再撕裂率为2/67(3.0%),非分层组再撕裂率为3/105(2.9%),没有显着差异（n.s.）。
结论：改良的关节镜下集体缝合桥技术可有效修复分层的RCT，产生与未分层的泪液相当的良好临床结局。
方法：四级。
