目的:本研究旨在探讨关节镜下肩峰下球囊置入治疗肩袖大面积撕裂(MRCT)的疗效,评估患者满意度,结果,肩部功能,疼痛评分,首次手术后8年的免修正生存率。
方法:在这项前瞻性数据收集的回顾性研究中,前瞻性纳入2014~2017年接受球囊置入的MRCT患者.在至少5年的随访中对其结果进行回顾性分析。人口统计,患者满意度,重新操作,并记录了并发症。计算SF-12评分和Constant-Murley评分(CMS)子评分的最小临床重要差异(MCID)。手术前和手术后的测量进行统计学比较,以进行解剖和功能评估。
结果:在一项最初有61名参与者的研究中,10人在3年内失去随访。在剩下的51人中,有9人在最新的后续行动中丢失了。队列(42名参与者,平均年龄63.17±7.66岁)监测83.98±9.50个月。七名与会者要求在两年内进行修订,导致83.33%的无修订生存率。从术前到最近的随访观察到显著的改善:肩眼肱骨间隔减少(7.83至6.56,p=0.004),临界肩角增加(36.10至38.24,p=0.001),骨关节炎等级增加(1.45至2.81,p=0.001),SF-12体质评分提高(27.40至37.69,p=0.001),Constant-Murley总分增加(26.50至68.69,p=0.001)。Constant-Murley总得分的MCID为11.78分。在那些没有修订的人中,满意率为11.43%,57.14%满意,31.43%的人不满意。
结论:在5年的随访中,使用球囊垫片进行MRCT可获得中等满意度,在头两年内具有稳定的修订率。值得注意的是,低翻修手术率,高无修订生存,在至少5年的随访中,通过关节镜下肩峰下球囊置入术,并结合二头肌肌腱切开术和肩峰下滑囊切除术进行MRCT,观察到肩部功能显着改善。
OBJECTIVE: To investigate the efficacy of arthroscopic subacromial balloon placement for massive rotator cuff tear (MRCT), assessing patient satisfaction, outcomes, shoulder functionality, pain scores, and revision-free survivorship up to 8 years after the initial surgery.
METHODS: In this retrospective study with prospective data collection, patients with MRCTs undergoing balloon placement from 2014 to 2017 were prospectively enrolled. Their outcomes were analyzed retrospectively over a minimum 5-year follow-up. Demographics, patient satisfaction, reoperations, and complications were documented. Minimal clinically important differences were calculated for 12-Item Short Form Health Survey scores and Constant-Murley score subscores. Pre- and postsurgery measures statistically compared for anatomic and functional evaluations.
RESULTS: In a study with 61 participants initially, 10 were lost to follow-up over 3 years. Of the remaining 51, 9 were lost at the latest follow-up. The cohort (42 participants, mean age 63.17 ± 7.66 years) was monitored for 83.98 ± 9.50 months. Seven participants required revisions within 2 years, resulting in an 83.33% revision-free survival rate. Significant improvements were observed from preoperative to latest follow-up: acromiohumeral interval decreased (7.83 to 6.56, P = .004), critical shoulder angle increased (36.10 to 38.24, P = .001), osteoarthritis grade increased (1.45 to 2.81, P = .001), 12-Item Short Form Health Survey physical score improved (27.40 to 37.69, P = .001), and Constant-Murley total scores increased (26.50 to 68.69, P = .001). Minimal clinically important difference for total Constant-Murley scores was 11.78 points. Among those without revisions, satisfaction rates were 11.43% excellent, 57.14% satisfied, and 31.43% dissatisfied.
CONCLUSIONS: Employing a balloon spacer for MRCTs yielded moderate satisfaction at the 5-year follow-up, with stable revision rates within the first 2 years. Notably, low revision surgery rates, high revision-free survival, and significant shoulder functionality improvements were observed at a minimum 5-year follow-up with arthroscopic subacromial balloon placement in conjunction with biceps tenotomy and subacromial bursectomy for MRCT.
METHODS: Level IV, retrospective study.