A new scale measuring translation of the humeral head as a prognostic factor for the treatment of large and massive rotator cuff tears.
A new scale measuring translation of the humeral head as a prognostic factor for the treatment of large and massive rotator cuff tears.
复制标题
测量肱骨头平移的新量表作为治疗大面积肩袖撕裂的预后因素。
DOI：
10.1016/j.jse.2017.08.026
复制
发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Chosa E.
中科院分区：
文献类型：
--
作者：
Taniguchi N;D'Lima DD;Suenaga N;Chosa E.
背景 对于大量撕裂的患者，肩袖修复后的失败率仍然很高。尽管肱骨头的高级平移已用于评估肩袖撕裂的严重程度，但肱骨头前移与临床结果的相关性尚未确定。本研究的目的是探讨 T 尺度（肱骨头前外侧平移的测量方法）作为肩袖修复预后因素的潜在作用。方法连续 120 名肩袖全层撕裂患者接受了肩袖初次修复。术前分别通过轴向计算机断层扫描和 X 线照片测量 T 尺度和肩肱间隔 (AHI)。研究了 T 量表和 AHI 与之前发布的分数和主动前仰角 (FE) 的相关性。比较术前 T 量表值呈阳性和阴性的患者的肩袖修复结果。结果 对于大至大量撕裂的患者，术前 T 量表（而非 AHI）与术后 FE 和临床评分显着相关，但对于小至中度撕裂的患者则不然。 T 量表值呈阳性的患者术后 FE 和临床评分显着高于 T 量表值呈负值的患者。 T-scale 值为负值的患者，再眼裂的相对风险要高出 2.0 至 7.9 倍。结论 T-scale 值为负值的大量撕裂伤患者的临床结果较差，再眼裂率较高。负 T 尺度值代表对于肩袖修复后具有较高再撕裂风险的患者考虑进行反向肩关节置换术的有用预后因素。
BackgroundFailure rates after rotator cuff repair remain high in patients with massive tears. Although superior translation of the humeral head has been used to assess the severity of rotator cuff tears, the relevance of anterior migration of the humeral head to clinical outcomes has not been established. The purpose of this study was to investigate the potential role of the T-scale, a measure of the anterolateral translation of the humeral head, as a prognostic factor for rotator cuff repair.MethodsOne hundred twenty consecutive patients with full-thickness rotator cuff tears underwent primary rotator cuff repair. The T-scale and acromiohumeral interval (AHI) were measured preoperatively on axial computed tomography scans and radiographs, respectively. The correlations of the T-scale and AHI with previously published scores and active forward elevation (FE) were investigated. The outcome of rotator cuff repairs was compared between patients with positive and patients with negative preoperative T-scale values.ResultsThe preoperative T-scale but not AHI correlated significantly with postoperative FE and clinical scores in patients with large to massive tears but not in those with small to medium tears. Postoperative FE and clinical scores were significantly higher in patients with positive T-scale values than in those with negative T-scale values. The relative risk of retear was 2.0 to 7.9 times greater in patients with negative T-scale values.ConclusionPatients with large to massive tears and negative T-scale values had poorer clinical outcomes and higher retear rates. A negative T-scale value represents a useful prognostic factor for considering reverse shoulder arthroplasty in patients at greater risk of retear after rotator cuff repair.
登录
查看更多内容
采用改良的经骨等效手术对大面积肩袖撕裂进行开放式修复：短期随访的初步结果
影响因子：
1.7
作者：
H. Yamaguchi;N. Suenaga;Naomi Oizumi;Yoshihiro Hosokawa;F. Kanaya
通讯作者：
F. Kanaya
影响因子：
4.8
作者：
Cho, Nam Su;Lee, Bong Gun;Rhee, Yong Girl
通讯作者：
Rhee, Yong Girl
影响因子：
3
作者：
Duralde, XA;Bair, B
通讯作者：
Bair, B
影响因子：
1.3
作者：
Yamaguchi H;Suenaga N;Oizumi N;Hosokawa Y;Kanaya F
通讯作者：
Kanaya F
影响因子：
3
作者：
Boileau, Pascal;Gonzalez, Jean-Francois;Walch, Gilles
通讯作者：
Walch, Gilles