Prospective Randomized Clinical Trial of Single-Versus Double-Row Suture Anchor Repair in 2-to 4-cm Rotator Cuff Tears: Clinical and Magnetic Resonance Imaging Results
Prospective Randomized Clinical Trial of Single-Versus Double-Row Suture Anchor Repair in 2-to 4-cm Rotator Cuff Tears: Clinical and Magnetic Resonance Imaging Results
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DOI：
10.1016/j.arthro.2010.11.059
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发表时间：
2011-04-01
影响因子：
4.7
通讯作者：
Yoo, Jae Chul
中科院分区：
文献类型：
--
作者：
Koh, Kyoung Hwan;Kang, Kyung Chung;Yoo, Jae Chul
目的：本研究的目的是比较关节镜下单排（SR）和双排（DR）缝线锚钉修复2至4 cm肩袖撕裂的临床结局和再撕裂率。研究方法：从2005年到2007年，71例肩袖撕裂2- 4 cm（经关节镜证实）的患者被前瞻性随机分配到SR和DR修复组。在这些患者中，62例（每组31例）可在最终随访时进行评价。比较人口统计学数据、临床评分、平均手术时间和患者满意度。还分析了47例接受随访磁共振成像的患者的再撕裂率和临床评分。结果如下：比较SR组和DR组的人口统计学数据、术前磁共振成像上的撕裂大小、总体脂肪变性指数和伴随手术没有差异。两组的术前临床评分术后均显著改善。最终随访时，疼痛视觉模拟量表、美国肩肘外科医生、Constant或加州大学洛杉矶分校评分无组间差异。两组之间仅平均手术时间存在显著差异。SR组有4例全层再撕裂和11例部分层再撕裂，而DR组有6例全层再撕裂和1例部分层再撕裂。然而，尽管存在数值差异，但这些差异无统计学差异。统计学上，两组之间的全层再撕裂（P = .999）和包括部分层撕裂的再撕裂（P = .124）均无显著差异。结论：本研究表明，在中度至重度肩袖撕裂患者中，使用1个额外内侧缝线锚进行DR修复的临床结果和再撕裂率与使用2个外侧缝线锚进行SR修复的临床结果和再撕裂率无显著差异。证据等级：I级，随机对照试验。
Purpose: The purpose of this study was to compare the clinical outcomes and the retear rates of arthroscopic single-row (SR) and double-row (DR) suture anchor repair in 2- to 4-cm rotator cuff tears. Methods: From 2005 to 2007, 71 patients with a 2- to 4-cm rotator cuff tear (proven by arthroscopy) were prospectively randomized to SR and DR repair groups. Of these patients, 62 (31 in each group) were available for evaluation at final follow-up. Demographic data, clinical scores, mean surgical times, and patient satisfaction were compared. Retear rates and clinical scores were also analyzed for 47 patients who underwent follow-up magnetic resonance imaging. Results: Comparisons of demographic data, tear size on preoperative magnetic resonance imaging, global fatty degeneration index, and concomitant procedures showed no differences between the SR and DR groups. Preoperative clinical scores were significantly improved postoperatively in both groups. No intergroup differences in pain visual analog scale, American Shoulder and Elbow Surgeons, Constant, or University of California, Los Angeles scores were found at final follow-up. Only mean surgical time was significantly different between the 2 groups. In the SR group, there were 4 full-thickness retears and 11 partial-thickness retears, whereas in the DR group, there were 6 full-thickness retears and 1 partial-thickness retear. However, despite numerical differences, these differences were not statistically different. Statistically, there were no significant differences both in full-thickness retear (P = .999) and retear including partial-thickness tear between the 2 groups (P = .124). Conclusions: This study indicates that the clinical results and retear rates of DR repair with 1 additional medial suture anchor were not significantly different from those of SR repairs with 2 lateral suture anchors in patients with medium to large rotator cuff tear. Level of Evidence: Level I, randomized controlled trial.