Guang Yang, Renjie Chen, Shangzhe Li, Hailong Zhang, Meng Zhou, Yi Lu
{"title":"温室技术在肩袖修复中提供更低的再撕裂率和相似的结果：一项前瞻性随机对照试验。","authors":"Guang Yang, Renjie Chen, Shangzhe Li, Hailong Zhang, Meng Zhou, Yi Lu","doi":"10.1016/j.jse.2025.05.030","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It is still an important issue to reduce the rate of retear after arthroscopic rotator cuff repair (ARCR). a new ARCR technique named \"Greenhouse technique\" combined with microfracture was proposed to enhance the rotator cuff healing. The purpose of this study was to compare the clinical outcomes and retear rate of Greenhouse technique (GH) with traditional single row repair (SR) in full-thickness rotator cuff tear (FT-RCT) patients in the early term follow-up. We hypothesized that the Greenhouse technique would provide lower retear rate and similar clinical outcomes in ARCR.</p><p><strong>Methods: </strong>From December, 2020 to March, 2021, 114 FT-RCT patients who received ARCR were randomized into 2 groups, Greenhouse group (56 patients) vs. SR group (58 patients). Functional outcomes including ASES, Constant-Murley, UCLA, SST, VAS for pain, range of motion (ROM) including forward elevation (FE), external rotation (ER) and internal rotation (IR) were evaluated preoperatively, 24 months postoperatively and compared between two groups. Tendon integrity was evaluated by MRI preoperatively and 2 years postoperatively. Bone tunnel healing was evaluated by CT at 3, 6 months postoperatively. Sugaya classification was used to evaluate tendon retear and compared between two groups. The percentage of patients reaching the minimal clinically important difference (MCID), patient acceptable symptoms state (PASS), substantial clinical benefit (SCB) based on ASES were also compared between two groups.</p><p><strong>Results: </strong>All functional outcomes and ROM improved significantly compared with preoperative index in both groups (all P <.001) at 24 months follow-up. However, there were no significant differences between 2 groups at final follow-up. Overall, 116 patients (85.7%) exceeded the MCID, 114 patients (73.3%) achieved the PASS, and 98 patients (85.0%) achieved SCB without significant differences between the 2 groups. The overall retear rate after ARCR in the GH group was 5.4% and 19.0% in the SR group separately, GH group had significantly lower retear rate than that in SR group(p=0.027). Bone tunnel in 49 patients (90.7%) disappeared in 3 months postoperatively.</p><p><strong>Conclusion: </strong>Both GH and SR groups achieved significant improvement after ARCR. Comparing with SR group, Greenhouse technique group provided lower retear rate and similar clinical outcomes in the early term follow-up.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Greenhouse technique provides lower re-tear rate and similar outcomes in rotator cuff repair: a prospective randomized controlled trail.\",\"authors\":\"Guang Yang, Renjie Chen, Shangzhe Li, Hailong Zhang, Meng Zhou, Yi Lu\",\"doi\":\"10.1016/j.jse.2025.05.030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>It is still an important issue to reduce the rate of retear after arthroscopic rotator cuff repair (ARCR). a new ARCR technique named \\\"Greenhouse technique\\\" combined with microfracture was proposed to enhance the rotator cuff healing. The purpose of this study was to compare the clinical outcomes and retear rate of Greenhouse technique (GH) with traditional single row repair (SR) in full-thickness rotator cuff tear (FT-RCT) patients in the early term follow-up. We hypothesized that the Greenhouse technique would provide lower retear rate and similar clinical outcomes in ARCR.</p><p><strong>Methods: </strong>From December, 2020 to March, 2021, 114 FT-RCT patients who received ARCR were randomized into 2 groups, Greenhouse group (56 patients) vs. SR group (58 patients). Functional outcomes including ASES, Constant-Murley, UCLA, SST, VAS for pain, range of motion (ROM) including forward elevation (FE), external rotation (ER) and internal rotation (IR) were evaluated preoperatively, 24 months postoperatively and compared between two groups. Tendon integrity was evaluated by MRI preoperatively and 2 years postoperatively. Bone tunnel healing was evaluated by CT at 3, 6 months postoperatively. Sugaya classification was used to evaluate tendon retear and compared between two groups. The percentage of patients reaching the minimal clinically important difference (MCID), patient acceptable symptoms state (PASS), substantial clinical benefit (SCB) based on ASES were also compared between two groups.</p><p><strong>Results: </strong>All functional outcomes and ROM improved significantly compared with preoperative index in both groups (all P <.001) at 24 months follow-up. However, there were no significant differences between 2 groups at final follow-up. Overall, 116 patients (85.7%) exceeded the MCID, 114 patients (73.3%) achieved the PASS, and 98 patients (85.0%) achieved SCB without significant differences between the 2 groups. The overall retear rate after ARCR in the GH group was 5.4% and 19.0% in the SR group separately, GH group had significantly lower retear rate than that in SR group(p=0.027). Bone tunnel in 49 patients (90.7%) disappeared in 3 months postoperatively.</p><p><strong>Conclusion: </strong>Both GH and SR groups achieved significant improvement after ARCR. Comparing with SR group, Greenhouse technique group provided lower retear rate and similar clinical outcomes in the early term follow-up.</p>\",\"PeriodicalId\":50051,\"journal\":{\"name\":\"Journal of Shoulder and Elbow Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-07-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Shoulder and Elbow Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jse.2025.05.030\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Shoulder and Elbow Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jse.2025.05.030","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The Greenhouse technique provides lower re-tear rate and similar outcomes in rotator cuff repair: a prospective randomized controlled trail.
Background: It is still an important issue to reduce the rate of retear after arthroscopic rotator cuff repair (ARCR). a new ARCR technique named "Greenhouse technique" combined with microfracture was proposed to enhance the rotator cuff healing. The purpose of this study was to compare the clinical outcomes and retear rate of Greenhouse technique (GH) with traditional single row repair (SR) in full-thickness rotator cuff tear (FT-RCT) patients in the early term follow-up. We hypothesized that the Greenhouse technique would provide lower retear rate and similar clinical outcomes in ARCR.
Methods: From December, 2020 to March, 2021, 114 FT-RCT patients who received ARCR were randomized into 2 groups, Greenhouse group (56 patients) vs. SR group (58 patients). Functional outcomes including ASES, Constant-Murley, UCLA, SST, VAS for pain, range of motion (ROM) including forward elevation (FE), external rotation (ER) and internal rotation (IR) were evaluated preoperatively, 24 months postoperatively and compared between two groups. Tendon integrity was evaluated by MRI preoperatively and 2 years postoperatively. Bone tunnel healing was evaluated by CT at 3, 6 months postoperatively. Sugaya classification was used to evaluate tendon retear and compared between two groups. The percentage of patients reaching the minimal clinically important difference (MCID), patient acceptable symptoms state (PASS), substantial clinical benefit (SCB) based on ASES were also compared between two groups.
Results: All functional outcomes and ROM improved significantly compared with preoperative index in both groups (all P <.001) at 24 months follow-up. However, there were no significant differences between 2 groups at final follow-up. Overall, 116 patients (85.7%) exceeded the MCID, 114 patients (73.3%) achieved the PASS, and 98 patients (85.0%) achieved SCB without significant differences between the 2 groups. The overall retear rate after ARCR in the GH group was 5.4% and 19.0% in the SR group separately, GH group had significantly lower retear rate than that in SR group(p=0.027). Bone tunnel in 49 patients (90.7%) disappeared in 3 months postoperatively.
Conclusion: Both GH and SR groups achieved significant improvement after ARCR. Comparing with SR group, Greenhouse technique group provided lower retear rate and similar clinical outcomes in the early term follow-up.
期刊介绍：
The official publication for eight leading specialty organizations, this authoritative journal is the only publication to focus exclusively on medical, surgical, and physical techniques for treating injury/disease of the upper extremity, including the shoulder girdle, arm, and elbow. Clinically oriented and peer-reviewed, the Journal provides an international forum for the exchange of information on new techniques, instruments, and materials. Journal of Shoulder and Elbow Surgery features vivid photos, professional illustrations, and explicit diagrams that demonstrate surgical approaches and depict implant devices. Topics covered include fractures, dislocations, diseases and injuries of the rotator cuff, imaging techniques, arthritis, arthroscopy, arthroplasty, and rehabilitation.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
