Does Arthroscopic Suture-Spanning Augmentation of Single-Row Repair Reduce the Retear Rate of Massive Rotator Cuff Tear?
Does Arthroscopic Suture-Spanning Augmentation of Single-Row Repair Reduce the Retear Rate of Massive Rotator Cuff Tear?
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DOI：
10.1177/0363546519836419
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发表时间：
2019-05-01
影响因子：
4.8
通讯作者：
Ma, Hsiao-Li
中科院分区：
文献类型：
--
作者：
Ma, Hsuan-Hsiao;Chen, Kun-Hui;Ma, Hsiao-Li
背景：已经提出了几种治疗大规模肩袖撕裂（mrct）的手术技术，但失败率仍然很高。单排缝合增强技术（SSA-SR）在尸体研究中被证明可以降低失败率，但在体内的结果尚不清楚。目的：确定MRCT修复时在SR修复中添加跨缝是否可以改善功能结果并降低失败率。研究设计：随机对照试验；证据等级2。方法：本研究纳入71例经MRCT诊断的患者。研究组（n = 35）接受SSA-SR修复。对照组（n = 36）接受SR修复。术前和术后24个月分别评估美国肩关节外科医生（American Shoulder and肘外科医生）评分、Constant评分、加州大学洛杉矶分校（UCLA）评分和疼痛视觉模拟量表。术后6个月安排磁共振成像评估肩袖。结果：术后6个月，总回收率为31.0%。SSA-SR组的复发率（14.3%）低于SR组（47.2%,P = 0.002）。在24个月时，与SR组相比，SSA-SR组的ase、Constant和UCLA评分明显改善（P < 0.05）。两组患者的评分均较术前有显著改善（P < 0.05）。结论：SSA-SR修复技术具有较好的功能和影像学效果。基于该技术良好的术后效果，SSA-SR修复技术可以作为MRCT修复的潜在治疗选择。注册：NCT03609164 （ClinicalTrials.gov标识符）。
Background: Several surgical techniques have been proposed for massive rotator cuff tears (MRCTs), but the failure rates remain high. The suture-spanning augmentation technique of single-row (SSA-SR) repair was shown to reduce failure rates in cadaveric studies, but the outcome in vivo remains unclear. Purpose: To determine if adding spanning sutures to SR repair during MRCT repairs can improve functional outcome and reduce failure rates. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: The study included 71 patients with a diagnosed MRCT. The study group (n = 35) received SSA-SR repair. The control (n = 36) received SR repair. The American Shoulder and Elbow Surgeons (ASES) score, Constant score, UCLA (University of California, Los Angeles) score, and visual analog scale for pain were assessed preoperatively and 24 months postoperatively. Magnetic resonance imaging was arranged at 6 months postoperatively to evaluate the rotator cuff. Results: At 6 months postoperatively, the overall retear rate was 31.0%. The retear rate was lower in the SSA-SR group (14.3%) than in the SR group (47.2%, P = .002). At 24 months, the SSA-SR group had markedly improved ASES, Constant, and UCLA scores in comparison with the SR group (P < .05). Within both groups, all scores had significant improvement as compared with the preoperative status (P < .05). Conclusion: The SSA-SR repair technique showed improved functional and radiologic results. Based on the superior postoperative outcome of this technique, the SSA-SR repair technique can be a potential treatment option for MRCT repair. Registration: NCT03609164 (ClinicalTrials.gov identifier).