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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Healing Rates of Massive Rotator Cuff Tears by Allograft Reconstruction vs Maximal Repair - A Prospective Randomized Controlled Trial
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Healing Rates of Massive Rotator Cuff Tears by Allograft Reconstruction vs Maximal Repair - A Prospective Randomized Controlled Trial

机译：同种异体移植修复与最大修复相比较的大型肩袖愈合率的前瞻性随机对照试验。

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Objectives: To determine the healing rate of rotator cuff reconstruction with an acellular human dermal allograft compared with the current gold standard arthroscopic maximal rotator cuff repair of large, chronic tears of the rotator cuff. Methods: Thirty patients with a two-tendon chronic retracted rotator cuff tear were enrolled in the study and were randomly allocated (15) to each group. All the patients were evaluated for structural integrity of repair using a 1.5 T MRI at an average of 15 months after surgery. Rotator cuff arthropathy (RCA) and acromio-humeral distance (AHD) were graded using X-rays. WORC, DASH, MARX scores, range of motion (ROM) of shoulder were also analyzed. Results: The re-tear rate in reconstruction group was 13% (2 of 15 patients) compared to 67%(10/15) in repair group (p=0.008). Progression of RCA was seen in 7.14%(1/14) and 35.71%(4/14) of patients in reconstruction and repair group; respectively (p=0.006). The change in AHD (preop-postop) was significantly higher in repair (reduced by 2.27 mm) than the reconstruction group (increased by 0.1 mm) (P=0.006). Both groups had significant improvements in patient reported outcome scores. Reconstruction group had statistically significant better forward flexion (p= 0.01) and scapular plane abduction (p=0.03) compared to repair. Conclusion: Rotator cuff reconstruction with a dermal allograft demonstrated favourable structural healing rates and improved range of motion compared to maximal repair in the short term. Moreover, those in the maximal repair group were more likely to develop RCA compared to reconstruction.
机译：目的：与目前使用的金标准关节镜最大旋转袖套修复大型，慢性撕裂的袖套相比，确定无细胞人类真皮同种异体移植物重建袖套的治愈率。方法：本研究纳入了30例两肌腱慢性缩回性肩袖撕裂患者，并将其随机分配（15）至每组。术后平均15个月，使用1.5 T MRI对所有患者的修复结构完整性进行评估。使用X射线对肩袖关节病（RCA）和肩肱距离（AHD）进行分级。还分析了WORC，DASH，MARX得分，肩膀的运动范围（ROM）。结果：重建组的再撕裂率为13％（15例中的2例），而修复组为67％（10/15）（p = 0.008）。重建和修复组患者的RCA进展分别为7.14％（1/14）和35.71％（4/14）。分别为（p = 0.006）。修复组（减少-2.27 mm）中AHD的变化（术前-术后）显着高于重建组（增加0.1 mm）（P = 0.006）。两组患者报告的结果得分都有显着改善。与修复组相比，重建组的前屈（p = 0.01）和肩cap骨外展（p = 0.03）有统计学意义。结论：与短期最大修复相比，采用真皮同种异体移植重建肩袖表现出良好的结构愈合率和改善的活动范围。而且，与修复相比，最大修复组的患者更有可能发生RCA。

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