背景:前旋转电缆在肩袖的力传递中至关重要。然而,很少有临床研究对肩袖撕裂患者的前冈上肌腱的完整性与手术结果之间的相关性进行研究.
目的:比较关节镜下修复全层肩袖撕裂的临床和结构结果,包括和不包括冈上肌腱的前断裂。
方法:队列研究;证据水平,3.
方法:关节镜肩袖修复后至少6个月,一百八十一个肩可用于磁共振成像(MRI),至少1年随访,已注册。旋转器电缆的前部连接在113个肩部(A组)中被破坏,在68个肩部(B组)中完好无损。A组和B组手术时的平均年龄分别为59.6岁和59.2岁,分别,平均随访时间为24.2个月和25.1个月,分别。
结果:两组术前泪液大小和模式以及肌肉脂肪变性差异有统计学意义(分别为P=.004,P=.008和P<.001)。在最后的后续行动中,A组和B组运动过程中疼痛评分的平均视觉模拟量表(VAS)为1.31±0.98和1.24±0.90,分别(P=.587)。A组和B组平均Constant评分分别为77.5±11.2分和78.0±11.9分,分别(P=.875)。加州平均大学,A组和B组洛杉矶评分分别为30.5±4.1和31.0±3.0分,分别(P=.652)。在评估术后MRI的修复完整性时,A组和B组的再撕率分别为23.9%和14.7%,分别为(P=0.029)。
结论:无论是否涉及旋转电缆的前附着,平均24个月的随访显示,关节镜肩袖修复术后疼痛缓解效果良好,日常生活活动能力得到改善.然而,旋转电缆前部破裂的泪液显示出明显更大,更复杂的泪液模式和更严重的脂肪变性。此外,撕裂累及旋转索前部附着的患者的再撕裂率明显较高.
BACKGROUND: The anterior rotator cable is critical in force transmission of the rotator cuff. However, few clinical studies have examined the correlation between the integrity of the anterior supraspinatus tendon and surgical outcomes in patients with rotator cuff tears.
OBJECTIVE: To compare the clinical and structural outcomes of the arthroscopic repair of full-thickness rotator cuff tears with and without anterior disruption of the supraspinatus tendon.
METHODS: Cohort study; Level of evidence, 3.
METHODS: One hundred eighty-one shoulders available for magnetic resonance imaging (MRI) at least 6 months after arthroscopic rotator cuff repair, with a minimum 1-year follow-up, were enrolled. The anterior attachment of the rotator cable was disrupted in 113 shoulders (group A) and intact in 68 shoulders (group B). The mean age at the time of surgery in groups A and B was 59.6 and 59.2 years, respectively, and the mean follow-up period was 24.2 and 25.1 months, respectively.
RESULTS: There were statistically significant differences in the preoperative tear size and pattern and muscle fatty degeneration between the 2 groups ( P = .004, P = .008, and P < .001, respectively). At final follow-up, the mean visual analog scale (VAS) for pain score during motion was 1.31 ± 0.98 and 1.24 ± 0.90 in groups A and B, respectively ( P = .587). The mean Constant score was 77.5 ± 11.2 and 78.0 ± 11.9 points in groups A and B, respectively ( P = .875). The mean University of California, Los Angeles score was 30.5 ± 4.1 and 31.0 ± 3.0 points in groups A and B, respectively ( P = .652). In assessing the repair integrity on postoperative MRI, the retear rate was 23.9% and 14.7% in groups A and B, respectively ( P = .029).
CONCLUSIONS: Irrespective of involvement in the anterior attachment of the rotator cable, the mean 24-month follow-up demonstrated excellent pain relief and improvement in the ability to perform activities of daily living after arthroscopic rotator cuff repair. However, tears with anterior disruption of the rotator cable showed a significantly larger and more complex tear pattern and more advanced fatty degeneration. Additionally, the retear rate was significantly higher in patients with a tear involving the anterior attachment of the rotator cable.