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首页> 外文期刊>Shoulder & elbow >Medium- to long-term results of a randomized controlled trial to assess the efficacy of arthoscopic-subacromial decompression versus mini-open repair for the treatment of medium-sized rotator cuff tears
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Medium- to long-term results of a randomized controlled trial to assess the efficacy of arthoscopic-subacromial decompression versus mini-open repair for the treatment of medium-sized rotator cuff tears

机译：评估关节镜下肩峰减压与小切口开放性修复治疗中型肩袖撕裂的疗效的随机对照试验的中长期结果

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Background: We report on the medium- to long-term results of a randomized controlled trial (RCT) aiming to determine whether rotator cuff repair confers any advantage over arthroscopic sub-acromial decompression (ASAD) alone in the management of medium-sized rotator cuff tears.Methods: Ethical approval was sought to follow-up patients previously enrolled in a completed and previously published RCT comparing the outcome of ASAD with mini-open cuff repair for the treatment of rotator cuff tear. Forty-two patients were enrolled in the original study, with a mean of 64 years (range 54 years to 77 years). Results: Fifteen of the original 17 patients randomized to ASAD alone and 18 of the original 25 patients randomized to cuff repair were available for follow-up. Each patient underwent American Shoulder and Elbow Surgeons (ASES), Disabilities of the Arm, Shoulder and Hand (DASH) and Constant scoring, and clinical and ultrasound examination. Mean duration of follow-up was 7 years (range 5 years to I I years). There was no statistically significant difference in terms of ASES, DASH and Constant scores at follow-up between the two groups. Some 33% of patients in the cuff-repair group had a proven re-rupture on ultrasound. This patient subgroup had significantly worse Constant scores compared to patients where the repair remained intact. None of the patients from either group developed cuff-tear arthropathy requiring arthroplasty surgery.Conclusions: In this medium- to longer-term study, there is no demonstrable significant benefit of cuff repair over decompression alone for the treatment of medium-sized rotator cuff tears, in terms of ASES, DASH and Constant scores for pain, function and strength modules. The presence of cuff tear does not necessitate surgical repair. This conclusion should drive surgical strategies and shared decision-making between patients and surgeons.
机译：背景：我们报告了一项随机对照试验（RCT）的中长期结果，旨在确定在中型肩袖的管理中，肩袖修补术是否比单纯关节镜下肩峰减压（ASAD）具有任何优势方法：寻求伦理学的批准，对先前纳入完整且先前发表的随机对照试验的患者进行随访，以比较ASAD与微型开放式袖套修补术治疗肩袖撕裂的疗效。最初的研究纳入了42位患者，平均64岁（54岁至77岁）。结果：随机选择单独接受ASAD的最初17例患者中有15例，随机进行袖套修复的最初25例患者中有18例可以进行随访。每位患者均接受美国肩膀和肘部外科医师（ASES），手臂，肩膀和手部残疾（DASH）和持续评分以及临床和超声检查。平均随访时间为7年（5年至I年）。两组之间在随访时的ASES，DASH和Constant评分无统计学差异。袖套修复组中约33％的患者经超声证实具有再次破裂的能力。与修复完好无损的患者相比，该患者亚组的Constant评分明显较差。两组患者均未发生需要进行关节置换手术的袖眼撕裂病。结论：在这项中长期研究中，对于中型肩袖撕裂的治疗，与单纯减压相比，袖套修复没有明显的显着益处。 ，就疼痛，功能和强度模块而言，根据ASES，DASH和Constant得分。袖带撕裂的存在无需手术修复。该结论应推动患者和外科医生之间的手术策略和共同的决策制定。

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