Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55 Years: A Prospective Comparative Study
Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55 Years: A Prospective Comparative Study
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DOI：
10.1177/0363546517728718
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发表时间：
2018-01-01
影响因子：
4.8
通讯作者：
Vlychou, Marianna
中科院分区：
文献类型：
--
作者：
Hantes, Michael E.;Ono, Yohei;Vlychou, Marianna
背景：当对年轻患者进行关节镜肩袖修复时，需要持久的结构和功能肌腱完整性。应考虑为年轻人群提供可能提供更好肌腱愈合的固定技术，以实现长期临床成功。假设/目的：目的是比较单排和双排（即缝线桥）固定技术在 55 岁以下患者进行关节镜肩袖修复时的放射学和临床中期结果。我们假设双排技术将改善肌腱愈合，从而产生优异的中长期临床结果。证据水平，2.方法：连续纳入66名年龄小于55岁的冈上肌和冈下肌腱全层撕裂的患者，接受关节镜下单排或双排（即缝线桥）修复术并进行前瞻性观察。 34 名患者和 32 名患者分别被分配到单排组和双排组。术后，在至少 12 个月内根据 Sugaya 分类通过 MRI 评估肌腱完整性，并在至少 2 年内使用 Constant 评分和加州大学洛杉矶分校 (UCLA) 评分评估临床结果。 结果：平均随访时间为 46 个月（范围为 28-50 个月）。与单排组相比，双排组获得了更高的肌腱愈合率（分别为 84% 和 61% [P < . 05]）。尽管两种技术之间的结果评分没有差异，但与肌腱再撕裂的患者相比，肌腱愈合的患者表现出更好的临床结果（UCLA 评分分别为 34.2 和 27.6 [P < .05]；恒定评分分别为 94 和 76 [P < . 05]）。 结论：与单排技术相比，双排修复技术可能提供更好的肌腱愈合。对于年龄小于 55 岁、肩袖中度至大度撕裂的患者，应考虑双排修复。
Background: When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success.Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and doublerow (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid-to long-term clinical outcomes.Study Design: Cohort study; Level of evidence, 2.Methods: A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya's classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years.Results: Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [P < . 05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [P < .05]; Constant score, 94 and 76, respectively [P < . 05]).Conclusion: The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.