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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Two-Year Outcomes Following Arthroscopic Treatment for Partial-Thickness Tears of the Supraspinatus Tendon
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Two-Year Outcomes Following Arthroscopic Treatment for Partial-Thickness Tears of the Supraspinatus Tendon

机译：关节镜下治疗上肢肌腱部分厚度眼泪的两年结果

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Objectives: Treatment for partial-thickness (PT) supraspinatus tears are largely based on surgeon intuition since little is known regarding the outcomes of specific treatment methods. Therefore, the purpose of this study was to evaluate the outcomes following arthroscopic management of partial-thickness supraspinatus tears. Methods: Institutional Review Board approval was obtained prior to initiation of this study. All data were prospectively collected and retrospectively analyzed. Between March 2006 and April 2011, 61 shoulders underwent arthroscopic treatment for PT supraspinatus tears. Inclusion criteria were: age >18 years, primary arthroscopic treatment for a PT supraspinatus tear, and were 2 years removed from the index surgery. Treatments included debridement (< 50% thickness), side-to-side repair with sutures and repair (> 50% thickness) using either single- (50-75%) or double-row (>75%) suture anchor constructs. Concomitant treatments were recorded. Demographic data were collected pre- and postoperatively along with ASES, SF-12 PCS, QuickDASH, SANE and satisfaction after minimum two-year follow-up. Data regarding intraoperative findings, treatments, complications and revision surgeries were collected. Treatment failure was defined as subsequent surgery on the supraspinatus tendon. Outcomes data were compared with preoperative baselines along with various demographic and surgical variables. Statistical significance was set at p<0.05. Results: 69 shoulders (38 men, 29 women, 2 bilateral) with a mean age of 52 years (range, 20-74) underwent arthroscopic treatment for PT supraspinatus tears. There were 2 complications (2.9%): 1 shoulder developed axillary nerve symptoms and 1 developed a superficial wound infection. 8 of the 69 shoulders (11.6%) underwent subsequent surgery on the index shoulder unrelated to the rotator cuff before final follow-up and were omitted from the outcomes analysis. 24/61 shoulders had bursal-sided tears (39.3%) and 37/61 had articular-sided tears (60.7%). 31 shoulders (50.8%) had a tear involving <25% of the tendon thickness. 35 tears (57.4%) were repaired whereas 26 tears (42.6%) underwent debridement alone. 28 shoulders also had proximal biceps tendon lesions (45.9%), 28 had SLAP tears (45.9%) and 18 had other pathologies. Treatment failure occurred in 4 shoulders (6.6%) and they were subsequently removed from outcomes analysis. 57 shoulders had a mean follow-up of 41.3 months (range, 24.0-74.2 months). All postoperative outcomes scores and pain scores improved significantly over preoperative baselines (p<0.05) (Table 1). ASES scores returned to levels of age-matched normals. Tears that underwent debridement only demonstrated significantly worse QuickDASH scores compared to the rest of the cohort (mean 12.0 [SE 4.3] versus mean 7.8 [SE 2.1]; p<0.05) whereas shoulders that underwent acromioplasty demonstrated significantly improved QuickDASH scores compared to the rest of the cohort (mean 6.8 [SE 2.1] versus mean 13.6 [SE 3.5]; p=0.026). Conclusion: Arthroscopic treatment for PT supraspinatus tears provides excellent outcomes and satisfaction in the majority of patients. There were no differences in outcomes between articular- versus bursal-sided supraspinatus tears; however, QuickDASH scores were affected negatively by debridement and positively by acromioplasty.
机译：目的：对部分厚度（PT）的棘上肌撕裂的治疗很大程度上基于外科医生的直觉，因为对具体治疗方法的结果知之甚少。因此，本研究的目的是评估关节镜处理部分厚度的上棘上泪后的结果。方法：在这项研究开始之前已获得机构审查委员会的批准。前瞻性收集所有数据并进行回顾性分析。在2006年3月至2011年4月之间，对61根肩关节进行了PT棘上泪的关节镜治疗。纳入标准为：年龄> 18岁，初次关节镜治疗PT上棘撕裂，并从索引手术中移除2年。治疗方法包括清创术（<50％厚度），使用缝合线进行侧向修复以及使用单行（50％至75％）或双行（> 75％）缝合线锚固结构修复（> 50％厚度）。记录伴随治疗。在至少两年的随访后，收集术前和术后以及ASES，SF-12 PCS，QuickDASH，SANE和满意度的人口统计学数据。收集有关术中发现，治疗，并发症和翻修手术的数据。治疗失败的定义是对棘上肌腱的后续手术。将结果数据与术前基线以及各种人口统计学和手术变量进行比较。统计学显着性设定为p <0.05。结果：平均年龄为52岁（20-74岁）的69例肩膀（38例男性，29例女性，双侧2例）接受了关节镜治疗PT棘上肌撕裂。有2例并发症（2.9％）：1例出现肩部腋神经症状，1例出现浅表伤口感染。 69例肩中的8例（11.6％）在最终随访之前接受了与肩袖无关的食指肩部后续手术，因此从结果分析中省略。 24/61的肩部为法氏囊侧眼泪（39.3％），而37/61的肩部为侧眼泪（60.7％）。 31个肩膀（50.8％）的眼泪占肌腱厚度的25％以下。仅修复了35眼泪（57.4％），而修复了26眼泪（42.6％）。 28例肩膀也有近端二头肌腱病变（45.9％），28例出现SLAP撕裂（45.9％），18例有其他病理。治疗失败发生在四个肩膀（6.6％），随后将其从结果分析中移除。 57例肩关节平均随访41.3个月（范围24.0-74.2个月）。所有术后结局评分和疼痛评分均较术前基线显着改善（p <0.05）（表1）。 ASES分数恢复到与年龄相匹配的正常水平。进行清创术的眼泪与其他人相比，QuickDASH评分明显差（平均12.0 [SE 4.3]对平均7.8 [SE 2.1]; p <0.05），而行肩峰成形术的肩膀与其他人相比，QuickDASH评分明显改善队列的平均值（平均值6.8 [SE 2.1]与平均值13.6 [SE 3.5]; p = 0.026）。结论：关节镜治疗PT棘上泪可为大多数患者提供出色的疗效和满意度。关节侧和法氏囊上睑上泪之间的转归没有差异。但是，QuickDASH评分受到清创术的负面影响，而受到肩峰成形术的积极影响。

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