关节镜检查修复大下骨头撕裂的第一个方面
Su Cheol Kim1, Hyun Gon Kim1, Jong Hun Park1
1Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
The American journal of sports medicine
|October 18, 2023
概括
关节镜修复大 subscapularis 撕裂显示了对III型撕裂的良好结果,但不是IV型撕裂. 诸如旋转缩和同时发生的脊上撕裂等因素会影响撕裂率和长期结果.
科学领域:
- 整形外科手术 整形外科手术
- 运动医学 运动医学
- 肌肉骨成像系统的成像
背景情况:
- 有限的长期数据存在于大 subscapularis (SSC) 撕裂的关节镜修复,特别是当与上 (SSP) 撕裂相结合时.
- 评估结构和临床结果对于了解这些程序的有效性至关重要.
研究的目的:
- 用MRI评估大SSC撕裂的关节镜修复的长期结构和临床结果.
- 为了确定SSC复发和手术修复后不良临床结果的预测因素.
主要方法:
- 一系列病例包括109名患有大型SSC撕裂 (Yoo和Rhee类型III或IV) 的患者,他们在2011-2019年期间接受了关节镜修复.
- 长期随访 (平均84个月),包括MRI评估和临床结果评估 (运动范围,功能评分,力量).
- 通过MRI分析SSP撕裂大小,旋转缩/脂肪透 (Goutallier) 和肌完整性 (Sugaya) 等因素.
主要成果:
- 整体SSC再撕裂率为8.3%,对于IV型 (25.0%) 的明显高于III型 (2.5%) 的撕裂 (P < .001).
- SSC再撕裂的独立预测因素包括大SSP撕裂大小 (OR1.5),SSC Goutallier等级4 (OR10.8) 和SSP Goutallier等级3或4 (OR0.02).
- 较差的临床结果 (34.2%) 与女性性别 (OR 7.7),SSC复发 (OR 8.2) 和SSP复发 (OR 4.7) 有关.
结论:
- 关节镜修复对于大型SSC类型III撕裂产生有希望的结构结果,但不是类型IV.
- SSC撕裂受旋转缩以及同时出现的SSP撕裂的存在/大小的影响.
- 患者的选择至关重要,因为女性的性别和复发严重影响长期的临床结果.
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