Repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair
Repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair
复制标题
DOI：
10.1177/0363546507313574
复制
发表时间：
2008-08-01
影响因子：
4.8
通讯作者：
Tibone, James E.
中科院分区：
文献类型：
--
作者：
Frank, Joshua B.;ElAttrache, Neal S.;Tibone, James E.
背景：关节镜下肩袖修复术后的成功愈合仍然是一个挑战。早期的研究表明，失败率相对较高。新的外科技术可能会提高愈合潜力。本研究的目的是提供关节镜下经骨等效缝线桥肩袖修复后修复部位完整性的客观评价。假设：使用经骨等效缝线桥技术修复肩袖撕裂在术后磁共振成像（MRI）评价中显示出更高的完好率。研究设计：病例系列;证据等级，4。方法：前25名使用经骨等效缝线桥技术接受关节镜下肩袖修复术的患者接受了术后肩关节的MRI评价。最短随访时间为1年。人口统计学，临床和手术因素，包括撕裂大小，evaluated.Results：术后MRI显示完整的手术修复部位在22 25例（88%）。18例患者中有16例（89%）仅限于冈上肌腱的撕裂完整。累及部分或全部冈下肌的冈上肌撕裂的完整率为86%（6/7例）。在这些撕裂中，3例被认为是巨大的（完全2肌腱或更大）。结论：经骨等效缝合桥技术在1年的影像学研究中显示出较高的愈合率。在采用该技术修复的前25例患者中，88%的患者在MRI评价中肩袖修复完好。与大多数标准关节镜肩袖修复系列相比，根据修复部位的完整性判断，这表明肩袖愈合良好。在该技术的早期报告中，持续性撕裂与年龄或初始撕裂大小无关;然而，这可能是由于样本量相对较小。
Background: Successful healing after arthroscopic rotator cuff repair remains a challenge. Earlier studies have shown a relatively high rate of failure. New surgical techniques may improve healing potential. The purpose of this study was to provide an objective evaluation of repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair.Hypothesis: Rotator cuff tears repaired using the transosseous-equivalent suture-bridge technique will show a higher intact rate on postoperative magnetic resonance imaging (MRI) evaluation.Study Design: Case series; Level of evidence, 4.Methods: The first 25 patients who underwent arthroscopic rotator cuff repair using the transosseous-equivalent suture-bridge technique underwent MRI evaluation of the postoperative shoulder. Minimum follow-up was 1 year. Demographic, clinical, and surgical factors, including tear size, were evaluated.Results: Postoperative MRI demonstrated intact surgical repair sites in 22 of 25 patients (88%). Tears limited to the supraspinatus tendon were intact in 16 of 18 patients (89%). Tears of the supraspinatus involving part or all of the infraspinatus showed an 86% intact rate (6 of 7 patients). Of these tears, 3 were considered massive (complete 2-tendon or greater). These demonstrated an intact cuff on MRI.Conclusions: The transosseous-equivalent suture-bridge technique demonstrates a high healing rate on imaging studies at 1 year. Of the first 25 patients repaired with the technique, 88% had an intact rotator cuff repair on MRI evaluation. This indicates excellent cuff healing, as judged by the intact repair sites, compared with most standard arthroscopic rotator cuff repair series. In this early report of the technique, a persistent tear could not be correlated with age or initial tear size; however, this may be due to the relatively small sample size.