OPERATIVE TREATMENT OF FAILED REPAIRS OF THE ROTATOR CUFF
OPERATIVE TREATMENT OF FAILED REPAIRS OF THE ROTATOR CUFF
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DOI：
10.2106/00004623-199274100-00009
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发表时间：
1992-12-01
影响因子：
5.3
通讯作者：
MUSSO, ES
中科院分区：
文献类型：
--
作者：
BIGLIANI, LU;CORDASCO, FA;MUSSO, ES
31例患者在先前进行的肩袖修复失败后进行了重复修复，并分析了原始失败的原因和重复修复的结果。临床情况复杂，多种因素导致失败。30名患者（97%）的肩袖大面积撕裂和28名患者（90%）的持续肩峰下撞击是最常见的失败因素，16名患者（52%）的重复修复总体结果令人满意，15名患者（48%）不满意。25名患者（81%）的疼痛缓解令人满意。然而，14名患者（45%）有持续的弱点，导致不满意的结果。与更好结果相关的因素是肩峰完整、三角肌起点完整以及肩袖剩余组织质量良好。与较差结果相关的因素包括既往肩峰外侧切除术、既往三角肌起点分离以及发现重复手术时可用的肩袖组织质量较差。持续疼痛是重复修复的主要指征。功能结果是不可预测的，特别是当袖带的组织较差并且三角肌起点先前已经分离时。
Thirty-one patients had a repeat repair after a failure of a previously performed repair of the rotator cuff, and the causes of the original failure and the results of the repeat repair were analyzed. The clinical situation was complex, with multiple factors contributing to the failures. A large or massive tear of the cuff in thirty patients (97 per cent) and persistent subacromial impingement in twenty-eight patients (90 per cent) were the most common factors associated with failure.The over-all result of the repeat repair was satisfactory in sixteen patients (52 per cent) and unsatisfactory in fifteen (48 per cent). Twenty-five patients (81 per cent) had satisfactory relief of pain. However, fourteen patients (45 per cent) had persistent weakness that led to an unsatisfactory result. The factors that were associated with a better result were an intact acromion, an intact origin of the deltoid muscle, and the finding that the remaining tissue of the rotator cuff was of good quality. The factors that were associated with an inferior result were a previous lateral acromionectomy, a previously detached origin of the deltoid muscle, and the finding that the tissue of the rotator cuff that was available at the time of the repeat operation was of poor quality. Persistent pain is the primary indication for a repeat repair. The functional results are not as predictable, especially when the tissue of the cuff is poor and the deltoid origin has been detached previously.