■肩峰下的囊被发现是一个丰富的,当地,间充质干细胞来源,但在肩袖修复期间被去除以进行可视化。该组织的再植入可以改善肩袖愈合。这项研究的目的是评估有或没有肩峰下滑囊再植术的肩袖修复的临床结果。
■年龄在37-77岁的全层或接近全层的冈上肌撕裂患者接受关节镜下经耳等效双排肩袖修复。在2019年7月之前的患者中,切除肩峰下滑囊以进行可视化,并丢弃。在2019年7月之后的患者中,使用连接到关节镜剃须刀的过滤装置收集肩峰下滑囊,并在完成肩袖修复时重新应用于肌腱的滑囊表面。术后6个月通过磁共振成像对滑囊患者进行肩袖完整性评估。最少18个月的临床结果(单一评估数字评估,美国肩肘外科医师,患者满意度)在法氏囊和非法氏囊队列之间进行了比较。
■共136例患者纳入研究(对照n=110,法氏囊n=26)。术前人口统计学和泪液特征在组间没有差异。对照组平均随访时间明显延长(对照组:3.2±0.7年;法氏囊:1.8±0.3年;P<.001)。对照组显示出显着更高的单一评估数字评估得分(对照:87.9±15.8,法氏囊:83.6±15.1,P=.037),未达到最小的临床重要差异。两组之间的美国肩肘外科医生和患者满意度评分相似。症状性再眼泪在组间没有显着差异(对照组:9.1%,布尔萨7.7%,P=.86)。对照组7例患者接受了再次手术(6.4%),与法氏囊组的0例患者相比(0%,P=.2)。通过Sugaya分类定义,在法氏囊患者上获得的术后六个月磁共振图像显示了85%的肩袖连续性(n=17/20)。
■用法氏囊组织增强肩袖修复似乎没有负面影响,考虑到这种组织的可及性和容易收获,应进行进一步研究,以评估其改善肌腱愈合或临床结局的潜力.
UNASSIGNED: The subacromial bursa has been found to be a rich, local, source of mesenchymal stem cells but is removed for visualization during rotator cuff repair. Reimplantation of this tissue may improve rotator cuff healing. The purpose of this
study is to evaluate clinical outcomes of rotator cuff repair with and without subacromial bursa reimplantation.
UNASSIGNED: Patients aged 37-77 with a full-thickness or near full-thickness supraspinatus tears underwent arthroscopic transosseous-equivalent double row rotator cuff repair. In patients prior to July 2019, the subacromial bursa was resected for visualization, and discarded. In patients after July 2019, the subacromial bursa was collected using a filtration device connected to an arthroscopic shaver and reapplied to the bursal surface of the tendon at the completion of the rotator cuff repair. Rotator cuff integrity was evaluated via magnetic resonance imaging on bursa patients at 6 months postoperatively. Minimum 18-month clinical outcomes (Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons, patient satisfaction) were compared between bursa and nonbursa cohorts.
UNASSIGNED: A total of 136 patients were included in the
study (control n = 110, bursa n = 26). Preoperative demographics and tear characteristics were not different between groups. Average follow-up was significantly longer in the control group (control: 3.2 ± 0.7 years; bursa: 1.8 ± 0.3 years; P < .001). The control group showed a significantly higher Single Assessment Numeric Evaluation score (control: 87.9 ± 15.8, bursa: 83.6 ± 15.1, P = .037) that did not meet minimum clinically important difference. The American Shoulder and Elbow Surgeons and patient satisfaction scores were similar between the groups. Symptomatic retears were not significantly different between groups (control: 9.1%, bursa 7.7%, P = .86). Seven patients in the control group underwent reoperation (6.4%), compared to 0 patients in the bursa group (0%, P = .2). Six-month postoperative magnetic resonance images obtained on bursa patients demonstrated 85% rotator cuff continuity (n = 17/20) as defined via Sugaya classification.
UNASSIGNED: Augmentation of rotator cuff repair with bursal tissue does not appear to have negative effects, and given the accessibility and ease of harvest of this tissue, further research should be performed to evaluate its potential for improved tendon healing or clinical outcomes.