Functional and Structural Outcomes of Single-Row Versus Double-Row Versus Combined Double-Row and Suture-Bridge Repair for Rotator Cuff Tears
Functional and Structural Outcomes of Single-Row Versus Double-Row Versus Combined Double-Row and Suture-Bridge Repair for Rotator Cuff Tears
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DOI：
10.1177/0363546511415660
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发表时间：
2011-10-01
影响因子：
4.8
通讯作者：
Kinoshita, Mitsuo
中科院分区：
文献类型：
--
作者：
Mihata, Teruhisa;Watanabe, Chisato;Kinoshita, Mitsuo
背景：虽然以前的生物力学研究从力学角度证明了缝合桥式肩袖修复优于双排修复，但没有文章描述这种手术的结构和功能结果。假设：关节镜下肩袖修复后的结构和功能结果可能在单排、双排和双排联合缝合桥（压缩双排）技术之间有所不同。研究设计：队列研究；证据水平，3。方法：对201例全层肩袖撕裂患者206例肩行关节镜下肩袖修复术。11例患者未随访。65个肩关节采用单排修复，23个肩关节采用双排修复，107个肩关节采用压缩双排技术修复。在肩袖修复后平均38.5个月（范围24-74个月）评估临床结果。术后采用Sugaya分类磁共振成像（MRI）确定袖带完整性。结果：关节镜下肩袖单排、双排和压缩双排技术修复后的复位率分别为10.8%、26.1%和4.7%。在大、厚重肩袖撕裂亚类中，压缩双排组（40例中有3例，7.5%）的再撕裂率显著低于单排组（8例中有5例，62.5%,P < 0.001）和双排组（12例中有5例，41.7%,P < 0.01）。所有3种技术的术后临床结果，有反撕的患者明显低于没有反撕的患者。结论：增加缝合桥可降低大、块状撕裂的再撕裂率。双排和缝线桥技术的联合使用具有最低的术后再撕率，是关节镜下修复肩袖肌腱的有效选择，因为有再撕的患者的术后功能结果不如无再撕的患者。
Background: Although previous biomechanical research has demonstrated the superiority of the suture-bridge rotator cuff repair over double-row repair from a mechanical point of view, no articles have described the structural and functional outcomes of this type of procedure.Hypothesis: The structural and functional outcomes after arthroscopic rotator cuff repair may be different between the single-row, double-row, and combined double-row and suture-bridge (compression double-row) techniques.Study Design: Cohort study; Level of evidence, 3.Methods: There were 206 shoulders in 201 patients with full-thickness rotator cuff tears that underwent arthroscopic rotator cuff repair. Eleven patients were lost to follow-up. Sixty-five shoulders were repaired using the single-row, 23 shoulders using the double-row, and 107 shoulders using the compression double-row techniques. Clinical outcomes were evaluated at an average of 38.5 months (range, 24-74 months) after rotator cuff repair. Postoperative cuff integrity was determined using Sugaya's classification of magnetic resonance imaging (MRI).Results: The retear rates after arthroscopic rotator cuff repair were 10.8%, 26.1%, and 4.7%, respectively, for the single-row, double-row, and compression double-row techniques. In the subcategory of large and massive rotator cuff tears, the retear rate in the compression double-row group (3 of 40 shoulders, 7.5%) was significantly less than those in the single-row group (5 of 8 shoulders, 62.5%, P < .001) and the double-row group (5 of 12 shoulders, 41.7%, P < .01). Postoperative clinical outcomes in patients with a retear were significantly lower than those in patients without a retear for all 3 techniques.Conclusion: The additional suture bridges decreased the retear rate for large and massive tears. The combination of the double-row and suture-bridge techniques, which had the lowest rate of postoperative retear, is an effective option for arthroscopic repair of the rotator cuff tendons because the postoperative functional outcome in patients with a retear is inferior to that without retear.