Atrophy of the deltoid muscle following rotator cuff surgery
Atrophy of the deltoid muscle following rotator cuff surgery
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DOI：
10.2106/00004623-200407000-00008
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发表时间：
2004-07-01
影响因子：
5.3
通讯作者：
Takaoka, K
中科院分区：
文献类型：
--
作者：
Hata, Y;Saitoh, S;Takaoka, K
背景：最近引入了微创手术，以促进肩袖修复后早日恢复运动或工作活动。然而，很少有报道证实这种手术是否真的比传统的开放式修复侵入性更小。本研究的目的是比较常规或迷你开放式肩袖修复术后三角肌的厚度。方法：1994 ~ 1997年对43例肩袖撕裂患者行常规切开修复术。迷你三角肌切开入路于1997年引入，并回顾了35例接受该手术的患者的病例。比较两组患者的三角肌前纤维厚度、主动前屈程度以及恢复工作和体育活动所需的时间。结果：小切口修复组术后三角肌前纤维厚度无明显变化，而切口修复组术后6个月和12个月三角肌前纤维厚度明显减少（p < 0.05）。术后3个月，加州大学洛杉矶分校（University of California At Los Angeles）微创修复组患者主动前屈的平均评分（4.9分）显著高于常规开放式修复组（4.6分）（p < 0.05）。此外，微创修复组平均恢复工作所需时间（2.4个月）明显短于对照组（3.4个月）（p < 0.05）。结论：与常规开放式肩袖修复术相比，小开口修复术术后三角肌萎缩更小，患者恢复更快。证据等级：治疗性研究，III-2级（回顾性队列研究）。有关证据水平的完整描述，请参见作者说明。
Background: Less invasive procedures have recently been introduced to facilitate an earlier return to sports or work activities after rotator cuff repair. Few reports, however, have verified whether such procedures are really less invasive than conventional open repair. The purpose of this study was to compare the postoperative thickness of the deltoid muscle in patients treated with either conventional or mini-open rotator cuff repair.Methods: Conventional open repair was performed from 1994 through 1997 in forty-three patients with rotator cuff tears. The mini-open deltoid-splitting approach was introduced in 1997, and the cases of thirty-five patients who underwent that procedure were reviewed. The two groups were compared with respect to the thickness of the anterior fibers of the deltoid muscle measured on the transverse magnetic resonance images, the degree of active forward flexion, and the times required for return to work and sports activities.Results: The thickness of the anterior deltoid fibers did not change significantly after surgery in the mini-open repair group, whereas it was significantly decreased in the open repair group at six months as well as at twelve months postoperatively (p < 0.05). At three months postoperatively, the mean University of California at Los Angeles score for active forward flexion in the patients treated with the mini-open repair (4.9 points) was significantly greater than that in the patients in the conventional open repair group (4.6 points) (p < 0.05). In addition, the mean time-period required for return to work in the mini-open repair group (2.4 months) was significantly shorter than that required in the control group (3.4 months) (p < 0.05).Conclusions: The mini-open repair appeared to cause less postoperative atrophy of the deltoid muscle than did the conventional open rotator cuff repair, and patients treated with the mini-open repair recovered more quickly.Level of Evidence: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.