Management of failed rotator cuff repair: a systematic review
Management of failed rotator cuff repair: a systematic review
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肩袖修复失败的管理：系统评价
DOI：
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
S. Burkhart
中科院分区：
文献类型：
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作者：
A. Lädermann;P. Denard;S. Burkhart
肩袖修复(RCR)后复发性撕裂是常见的。保守的、开放的和关节镜下的翻修术是治疗这些失败的主张。目的或目的：这项系统性综述的目的是评估治疗复发性肩袖撕裂的不同选择。证据回顾从2000年1月至2015年10月，对I级至4级研究进行检索，以确定报告RCR失败的研究。共鉴定出10篇文章。证据的整体质量非常低。结果保守治疗的患者的中长期随访显示结果可接受；持续性缺陷是一种耐受性良好的情况，仅偶尔需要进行后续手术。大多数患者可能需要保守治疗，特别是在受累于后上关节和术前活动范围不佳的情况下。年轻的患者如果有可修复的损伤，肌腱撕裂，以及肩胛下肌腱受累，可能需要进行翻修手术。结论和相关性目前的综述表明，尽管有很高的再撕裂率，关节镜下翻修RCR仍能改善功能预后。还需要进一步的研究，以便在原发性肩袖衰竭的情况下开展具体的康复治疗，更好地了解每种治疗方案的位置，并在修复的情况下，优化肌腱愈合。
Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing.
非手术治疗失败后修复有症状的肩袖撕裂具有成本效益：对 Richard C. Mather III 医学博士等人的文章的评论：“肩袖修复的社会和经济价值”。
DOI：
10.2106/jbjs.m.01223
发表时间：
2013
期刊：
The Journal of bone and joint surgery. American volume
影响因子：
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作者：
Bell,John-Erik
通讯作者：
Bell,John-Erik