Subacromial spacer implantation for massive rotator cuff tears: Clinical outcome of arthroscopically treated patients.

IF 0.5 Q4 ORTHOPEDICS

Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand Pub Date : 2017-01-01 Epub Date: 2016-12-01 DOI:10.1007/s11678-016-0386-9

Malte Holschen, Florian Brand, Jens D Agneskirchner

{"title":"Subacromial spacer implantation for massive rotator cuff tears: Clinical outcome of arthroscopically treated patients.","authors":"Malte Holschen, Florian Brand, Jens D Agneskirchner","doi":"10.1007/s11678-016-0386-9","DOIUrl":null,"url":null,"abstract":"Background: Massive rotator cuff tears (MRCT) can be treated arthroscopically by partial reconstruction, tenotomy/tenodesis of the long head of the biceps, and debridement. A new treatment option is the additional implantation of a biodegradable spacer (InSpace Balloon®; ISB) into the subacromial space, which reduces subacromial shear forces to keep the humeral head centered in the glenoid. The aim of this study is to investigate the clinical outcome of patients with MRCT who were treated arthroscopically with or without an additional ISB.Methods: The clinical outcome of patients treated with conventional arthroscopic techniques (n = 11, group A, partial repair, biceps tenotomy, and debridement) and that of patients treated with a supplementary ISB (n = 12, group B) was retrospectively analyzed. Preoperatively and postoperatively, shoulder function was assessed with the Constant and American Shoulder and Elbow Surgeons (ASES) scores. At follow-up after a mean of 22 months, patients filled out a questionnaire about their subjective satisfaction.Results: Preoperative shoulder function was lower in patients treated with an ISB (ASES score: group A, 59.1; group B, 31.5; Constant score: group A, 60.7; group B, 36.8). At follow-up, both groups had improved shoulder function (Constant score: group A, 60.7-77.6; p < 0.001; group B, 36.8-69.5; p < 0.001; ASES score: group A, 59.1-88.6; p < 0.001; group B, 31.5-85.7; p < 0.001). Patients in both groups were subjectively satisfied with their outcome.Conclusion: The ISB is a feasible treatment option for MRCT, providing subjective pain relief and improved shoulder function. Further studies with larger patient collectives and longer follow-up are needed to confirm whether it is a safe and cost-effective treatment.","PeriodicalId":43682,"journal":{"name":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","volume":"12 1","pages":"38-45"},"PeriodicalIF":0.5000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11678-016-0386-9","citationCount":"68","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s11678-016-0386-9","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2016/12/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 68

Abstract

Background: Massive rotator cuff tears (MRCT) can be treated arthroscopically by partial reconstruction, tenotomy/tenodesis of the long head of the biceps, and debridement. A new treatment option is the additional implantation of a biodegradable spacer (InSpace Balloon®; ISB) into the subacromial space, which reduces subacromial shear forces to keep the humeral head centered in the glenoid. The aim of this study is to investigate the clinical outcome of patients with MRCT who were treated arthroscopically with or without an additional ISB.

Methods: The clinical outcome of patients treated with conventional arthroscopic techniques (n = 11, group A, partial repair, biceps tenotomy, and debridement) and that of patients treated with a supplementary ISB (n = 12, group B) was retrospectively analyzed. Preoperatively and postoperatively, shoulder function was assessed with the Constant and American Shoulder and Elbow Surgeons (ASES) scores. At follow-up after a mean of 22 months, patients filled out a questionnaire about their subjective satisfaction.

Results: Preoperative shoulder function was lower in patients treated with an ISB (ASES score: group A, 59.1; group B, 31.5; Constant score: group A, 60.7; group B, 36.8). At follow-up, both groups had improved shoulder function (Constant score: group A, 60.7-77.6; p < 0.001; group B, 36.8-69.5; p < 0.001; ASES score: group A, 59.1-88.6; p < 0.001; group B, 31.5-85.7; p < 0.001). Patients in both groups were subjectively satisfied with their outcome.

Conclusion: The ISB is a feasible treatment option for MRCT, providing subjective pain relief and improved shoulder function. Further studies with larger patient collectives and longer follow-up are needed to confirm whether it is a safe and cost-effective treatment.

Abstract Image

查看原文本刊更多论文

肩峰下垫片植入治疗大面积肩袖撕裂:关节镜治疗患者的临床结果。

背景:大量肩袖撕裂(MRCT)可通过关节镜下部分重建、肱二头长头肌腱切断术/肌腱固定术和清创治疗。一种新的治疗选择是额外植入可生物降解的垫片(InSpace Balloon®;ISB)进入肩峰下间隙，这减少了肩峰下剪切力，保持肱骨头位于肩胛盂中心。本研究的目的是调查MRCT患者在关节镜下接受或不接受额外ISB治疗的临床结果。方法:回顾性分析采用常规关节镜技术(A组，n = 11例，部分修复，肱二头肌肌腱切断术，清创)和辅助ISB治疗(B组，n = 12例)的临床结果。术前和术后，采用Constant和American肩关节外科医生(ASES)评分评估肩关节功能。在平均22个月后的随访中，患者填写了一份关于他们主观满意度的问卷。结果:ISB患者术前肩功能较低(as评分:A组，59.1;B组，31.5;恒分:A组，60.7分;B组，36.8)。随访时，两组患者肩关节功能均有改善(恒定评分:A组，60.7-77.6;P < 0.001;B组36.8 ~ 69.5;P < 0.001;as评分:A组59.1-88.6;P < 0.001;B组31.5 ~ 85.7分;P < 0.001)。两组患者主观上均对治疗结果满意。结论:ISB是一种可行的MRCT治疗选择，提供主观疼痛缓解和改善肩功能。需要对更大的患者群体和更长时间的随访进行进一步研究，以确认它是否是一种安全且具有成本效益的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Obere Extremitaet-Schulter-Ellenbogen-Hand-Upper Extremity-Shoulder Elbow Hand ORTHOPEDICS-

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： Zielsetzung der Zeitschrift Die Zeitschrift Obere Extremität widmet sich der Versorgung von Verletzungen, Verletzungsfolgen und Erkrankungen im Bereich des Schulter- und des Ellenbogengelenks. Frei eingereichte Originalien präsentieren Forschungsergebnisse aktueller Studien im Bereich der Schulter- und Ellenbogenchirurgie und fördern den wissenschaftlichen Austausch. Vielversprechende Studien, die derzeit durchgeführt werden, sind ebenso willkommen, wie Langzeitstudien, die bewährte Verfahren auf den Prüfstand stellen. Fallberichte beleuchten seltene Indikationen und schildern ungewöhnliche Behandlungsverläufe. Umfassende Übersichtsarbeiten zu einem aktuellen Schwerpunktthema sind das Kernstück jeder Ausgabe. Im Mittelpunkt steht gesichertes Wissen mit hoher Relevanz für die tägliche Arbeit in der Schulter- und Ellenbogenchirurgie. Zusätzlich wird in speziellen Rubriken über innovative Behandlungsmaßnahmen, Probleme in der Begutachtung, berufspolitische Entwicklungen und Kongressaktivitäten berichtet. Als gemeinsames Kommunikations- und Weiterbildungsforum für alle Chirurg*innen und Orthopäd*innen mit entsprechender Spezialisierung ist die Zeitschrift Obere Extremität zukunftsorientiert und schließt eine wichtige Lücke im orthopädisch-unfallchirurgischen Informationsangebot. Aims & scope The journal Obere Extremität (Upper Extremity) is dedicated to the treatment of injuries, consequences of injuries and diseases in the area of the shoulder and elbow joint. Freely submitted originals present research results of current studies in the field of shoulder and elbow surgery and promote scientific exchange. Promising studies that are currently being carried out are welcome, as are long-term studies that put proven procedures to the test. Case reports illuminate rare indications and describe unusual courses of treatment. Comprehensive reviews on a current focus topic are the core of each issue. The focus is on secured knowledge with high relevance for the daily work in shoulder and elbow surgery. In addition, special sections report on innovative treatment measures, problems in assessment, professional policy developments and congress activities. As a joint communication and further education forum for all surgeons and orthopaedic surgeons with appropriate specialisation, the journal Obere Extremität is future-oriented and closes an important gap in the orthopaedic trauma surgery information offer. Begutachtung / Peer Review Alle Beiträge, die bei der Zeitschrift Obere Extremität eingereicht werden (einschließlich der eingeladenen Manuskripte) durchlaufen ein Doppelblind-Peer-Review-Verfahren, an dem mindestens zwei unabhängige Experten beteiligt sind.--- All manuscripts submitted to the journal Obere Extremität (including invited manuscripts) undergo a double-blind peer review process involving at least two independent experts. Ethische Richtlinien / Best Practice Guidelines and Publication Ethics Die Zeitschrift Obere Extremität folgt den Richtlinien des Komitees für Publikationsethik (COPE). Autoren wird empfohlen, klinische Studien, die sie zur Veröffentlichung in Betracht ziehen, vor der Veröffentlichung in kostenlosen, öffentlichen Registern für klinische Studien (z.B. www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) zu registrieren. Die Register sind nach den Richtlinien des International Committee of Medical Journal Editors (ICMJE) zu genehmigen. Die Autor*innen sollten am Ende ihres Abstracts den Namen des Studienregisters und ihre Registriernummer für klinische Studien angeben. The journal Obere Extremität (Upper Extremity) follows the Committee of Publications Ethics (COPE) - Guidelines. Authors are recommended to register clinical trials they consider for publication in free, public clinical trial registries (e.g., www.clinicaltrials.gov, http://clinicaltrials.ifpma.org, http://isrctn.org, www.germanctr.de/online-Register_de.html) before publication. The registries are to be approved by the guidelines of the International Committee of Medical Journal Editors (ICMJE). Authors should include the name of the trial register and their clinical trial registration number at the end of their abstract. Deklaration von Helsinki / Declaration of Helsinki Alle zur Veröffentlichung eingereichten Manuskripte, die Ergebnisse von Studien an Proband*innen oder Patient*innen präsentieren, müssen gemäß den Autorenrichtlinien für Originalarbeiten der Deklaration von Helsinki entsprechen. All Manuscripts submitted for publication presenting results from studies on probands or patients must comply with the Declaration of Helsinki according to the author guidelines for original papers.