滑囊内侧福斯伯里翻转撕裂与肌腱撕脱伤相比，关节镜下肩袖修复的临床和放射学效果

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-02-09 DOI:10.1016/j.asmr.2023.100879

Sean W.L. Ho M.D. , Tiago Martinho M.D. , Arash Amiri M.D. , Jeanni Zbinden M.D. , Xue Ling Chong M.D. , Hugo Bothorel M.E. , Philippe Collin M.D. , Alexandre Lädermann M.D.

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引用次数: 0

摘要

目的确定内侧滑囊侧 Fosbury 翻转肩袖撕裂手术修复后的临床和放射学结果，并与传统的肌腱附件撕脱病变进行比较。方法进行了一项回顾性队列研究。研究招募了所有接受过关节镜后上方修复术的患者。曾接受过肩关节肩袖手术的患者除外。招募的患者分为两组：一组为Fosbury翻转撕裂，另一组为标准撕脱性损伤。术前记录了患者的年龄、性别和手臂优势等人口统计学特征。在术前、术后 6 个月和至少 1 年的 3 个时间点对患者的活动范围（ROM）、疼痛和满意度视觉模拟量表（VAS）、常量评分、单字母数字评估评分和美国肩肘外科医生评分进行评估。结果共招募了 236 例患者，其中 27 例（11.4%）为 Fosbury 翻转撕裂，209 例（88.6%）为肌腱撕脱。虽然两组患者的性别或手臂优势无明显差异，但 Fosbury 翻转撕裂患者的年龄明显较大（P < .05），平均年龄为 61.6 岁（标准差 9.0），而肌腱撕脱患者的平均年龄为 56.1 岁（标准差 9.1）。两组在肌腱回缩方面没有明显差异。两组患者的 ROM、视觉模拟量表、美国肩肘外科医生（American Shoulder and Elbow Surgeons）单字母数字评估和恒定评分在术后 6 个月和至少 1 年都有明显改善。两组的 ROM 和临床评分无明显差异。Fosbury Flop撕裂的再撕裂率为7.4%（2/27），而肌腱撕脱的再撕裂率为2.8%（6/209），两者差异不显著（P = .361）。这些结果与手术修复的撕脱性损伤相当，关节镜修复后的再撕裂率可接受。

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Clinical and Radiologic Outcomes of Arthroscopic Rotator Cuff Repair in Medial Bursal-Side Fosbury Flop Tears Compared With Tendinous Avulsion Lesions

Purpose

To determine the clinical and radiologic outcomes after surgical repair of medial bursal-side Fosbury flop rotator cuff tears compared with traditional avulsion of tendinous attachments lesions.

Methods

A retrospective cohort study was performed. All patients who had undergone arthroscopic posterosuperior repair were recruited. Patients with previous shoulder rotator cuff surgery were excluded. Recruited patients were divided into 2 groups: one presenting Fosbury flop tears and the other presenting with standard avulsion lesions. Preoperative demographics such as age, gender, and arm dominance were recorded. Range of motion (ROM), visual analog scale (VAS) for pain and satisfaction, Constant score, Single Alpha-Numeric Evaluation score, and American Shoulder and Elbow Surgeons score were evaluated at 3 points in time: preoperatively, and at 6 months and minimum 1-year postoperatively. The healing of repaired cuffs was evaluated by ultrasound at 6 months.

Results

Two hundred thirty-six patients were recruited, with 27 (11.4%) Fosbury flop tears and 209 (88.6%) tendon avulsions. Although there was no significant difference in gender or arm dominance between the groups, Fosbury flop tears had significantly older patients (P < .05) with a mean age 61.6 years (standard deviation 9.0), compared with tendon avulsions with a mean age of 56.1 years (standard deviation 9.1). There was no significant difference in tendon retraction between the groups. Both groups demonstrated significant improvement in ROM, visual analog scale, American Shoulder and Elbow Surgeons, Single Alpha-Numeric Evaluation, and Constant score postoperatively at 6 months and minimum 1 year. The groups demonstrated no significant difference in the ROM and clinical scores. There was a nonsignificant difference in re-tear rate of 7.4% (2/27) in Fosbury flop tears compared with 2.8% (6/209) in tendon avulsions (P = .361).

Conclusions

Arthroscopic rotator cuff repair of medial bursal side Fosbury Flop rotator cuff tears results in favorable clinical and radiologic outcomes at 4 years after surgery. These outcomes are comparable with surgically repaired avulsion lesions, with an acceptable retear rate after arthroscopic repair.