Time to Failure After Rotator Cuff Repair A Prospective Imaging Study
Time to Failure After Rotator Cuff Repair A Prospective Imaging Study
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DOI：
10.2106/jbjs.l.00708
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发表时间：
2013-06-05
影响因子：
5.3
通讯作者：
Rodeo, Scott
中科院分区：
文献类型：
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作者：
Iannotti, Joseph P.;Deutsch, Allen;Rodeo, Scott
背景：肩袖修复后肌腱愈合失败的磁共振成像(MRI)显示为肌腱内充满液体的缺陷。肌腱修复失败的频率及其相关因素一直是许多临床研究的焦点。据我们所知，这些缺陷发生的时间之前还没有在大量预期确定的患者群体中进行研究。我们的假设是，大多数失败发生在手术后12周内。方法：113名患者参加了一项多机构的前瞻性研究。所有患者都接受了标准的关节镜下修复1到4厘米的全层撕裂，并进行了从两周到52周的六次顺序MRI检查。核磁共振成像在成像时由治疗的外科医生审查。结果：113例患者中，19例(17%)术后1年内MRI诊断为复发性撕裂。平均再撕裂时间为19.2周。在术后26周内，再撕裂呈直线增加，在修复后26-52周期间又发现1例再撕裂。结论：再撕裂主要发生在关节镜下肩袖修复术后6-26周，此后很少再发生撕裂。大量的再撕裂发生在修复后12到26周之间。
Background: Failure of tendon healing after a rotator cuff repair is demonstrated by magnetic resonance imaging (MRI) as a fluid-filled defect within the tendon. The frequency of, and factors associated with, failure of the tendon repair to heal have been the focus of many clinical studies. The timing of when these defects occur has not been previously studied in a large prospectively defined patient population, to our knowledge. It was our hypothesis that the majority of failures occur within twelve weeks after surgery.Methods: One hundred and thirteen patients were enrolled in a multi-institutional prospective study. All patients had a standardized arthroscopic repair of a full-thickness tear of 1 to 4 cm as well as sequential MRI studies at six intervals from two weeks to fifty-two weeks. MRIs were reviewed at the time of imaging by the treating surgeon. Standardized patient-oriented clinical data were collected, physical examination was performed, and strength measurements were made preoperatively and postoperatively.Results: The treating surgeons diagnosed a recurrent tear with MRI in nineteen (17%) of the 113 patients within one year after surgery. The mean time to the retear was 19.2 weeks. There was a linear increase in retears over the first twenty-six weeks after surgery, and one additional tear was diagnosed between twenty-six and fifty-two weeks after repair.Conclusions: Retears primarily occur between six and twenty-six weeks after arthroscopic rotator cuff repair, and few additional tears occur thereafter. A substantial number of retears occur between twelve and twenty-six weeks after repair.