Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: Technique and preliminary results
Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: Technique and preliminary results
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DOI：
10.1016/j.arthro.2003.11.013
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发表时间：
2004-01-01
影响因子：
4.7
通讯作者：
Burkhart, SS
中科院分区：
文献类型：
--
作者：
Lo, IKY;Burkhart, SS
目的：本研究的目的是描述关节镜下使用间隔滑动技术修复大块、收缩、不活动的肩袖撕裂的技术和初步结果。研究类型：案例系列。方法：1999年1月至2000年12月，对94例大面积肩袖撕裂进行了关节镜下肩袖修复术。其中9例（9.6%）为严重收缩的肩袖撕裂，需要采用间歇滑动技术进行修复。6例采用单段滑片，3例采用双段滑片。所有患者术前和术后均采用改良的加州大学洛杉矶分校（UCLA）评分系统进行评估。结果：平均随访17.9个月（10 ~ 24个月），9例患者中有8例满意。平均UCLA评分由术前10.0分上升至术后28.3分（P < 0.00001）。所有患者的主动运动、力量或功能均有所改善。主动前屈明显改善，从术前平均108度到术后平均146.1度（P = 0.025）。主动外旋从术前平均24.4度显著增加到术后平均35.0度（P = 0.04）。强度等级（2.2至3.6;P < 0.005）和功能（2.5至7.1;P < 0.005）也显著增加。我们在手术中没有遇到明显的并发症。结论：间歇滑动技术提供了一种大规模、严重收缩、不活动的肩袖撕裂的移动方法，可以修复先前无法修复的撕裂。该技术与关节镜下肩袖修复术相结合，可以改善患者的疼痛、活动、力量和整体肩功能。证据等级：四级。
Purpose: The purpose of this study is to describe the technique and review the preliminary results of arthroscopic repair of massive, contracted, immobile rotator cuff tears using an interval slide technique. Type of Study: Case series. Methods: From January 1999 to December 2000, the senior author (S.S.B.) performed arthroscopic rotator cuff repair on 94 massive rotator cuff tears. Of these, 9 (9.6%) were massive, severely contracted rotator cuff tears and required repair using an interval slide technique. A single interval slide was used in 6 patients, and a double interval slide was used in 3 patients. All patients were evaluated preoperatively and postoperatively using a modified University of California Los Angeles (UCLA) scoring system. Results: At a mean follow-up time of 17.9 months (range, 10-24 months), 8 of 9 patients were satisfied with the procedure. The mean UCLA score increased from 10.0 preoperatively to 28.3 postoperatively (P < .00001). All patients showed some improvement in active motion, strength, or function. Active forward flexion improved significantly, from a preoperative mean of 108degrees to a postoperative mean of 146.1degrees (P = .025). Active external rotation increased significantly from a preoperative mean of 24.4degrees to a postoperative mean of 35.0degrees (P = .04). A significant increase in strength grade (2.2 to 3.6; P < .005) and function (2.5 to 7.1; P < .0005) were also seen. We encountered no significant complications to the procedure. Conclusions: The interval slide technique provides a method of mobilization of massive, severely contracted, immobile rotator cuff tears allowing repair of previously irreparable tears. This technique, in conjunction with arthroscopic rotator cuff repair, may provide patients with improvements in pain, motion, strength, and overall shoulder function. Level of Evidence: Level IV.