The clinical effect of “Chinese way” in the treatment of massive rotator cuff injury under arthroscopy

doi:10.3969/j.issn.1006-7795.2022.05.020

Abstract

Abstract: Objective To evaluate the effect of “Chinese way” in the treatment of massive rotator cuff injury under arthroscopy and its therapeutic effect. Methods A retrospective analysis was performed on the clinical data of patients with unilateral massive rotator cuff injury treated by “Chinese way” method in Beijing Chaoyang Hospital from January 2019 to September 2021. A total of 42 patients met the inclusion criteria, including 23 males and 19 females, aged 45－76 years, with an average age of (57.2±6.3) years. During the operation, the long head of biceps tendon was transposed to the footprint area and fixed with an internal row anchor tail suture. The remaining rotator cuff fracture was repaired with a double-row anchor bridge technique. The range of motion, pain and function scores of the shoulder joint were statistically analyzed before surgery, 6 months, 1 year and 2 years after surgery, and the basic operation situation, postoperative complications and imaging results of the patients were recorded. Results All 42 patients in this group were successfully operated, and no serious complications occurred during or after operation. All patients were followed up for 6－24 months, with an average of (13.2±4.2) months. Anova of single factor repeated measurement showed that there were statistically significant differences in the range of motion, pain and functional score between the six months after surgery and the last follow-up (P< 0.01). X-ray examination indicated that there was no obvious progress in shoulder degeneration. Magnetic resonance imaging (MRI) examination revealed retears of reconstructed rotator cuff tissue in 6 patients, with an incidence of 14.3% (6/42). Conclusions The “Chinese way” method for repairing massive rotator cuff injury can reduce pain symptoms, improve range of motion and restore joint function, with lower rate of complications and structural failure, which is worth promoting in clinical practice.

Key words: shoulder joint, arthroscopy, massive rotator cuff injury, suture bridge technology, long head of biceps tendon

CLC Number:

R684

Zhang Bo, Lin Yuan, Ren Shixiang, Chen Tong, Yu Yang, Jia jialin. The clinical effect of “Chinese way” in the treatment of massive rotator cuff injury under arthroscopy[J]. Journal of Capital Medical University, 2022, 43(5): 792-798.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2022.05.020

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2022/V43/I5/792

References

[1] Heifner J J, Kumar A D, Wagner E R. Glenohumeral osteoarthritis with intact rotator cuff treated with reverse shoulder arthroplasty: a systematic review[J]. J Shoulder Elbow Surg, 2021, 30(12): 2895－2903.
[2] Shepet K H, Liechti D J, Kuhn J E. Nonoperative treatment of chronic, massive irreparable rotator cuff tears: a systematic review with synthesis of a standardized rehabilitation protocol[J]. J Shoulder Elbow Surg, 2021, 30(6): 1431－1444.
[3] Mori D, Kizaki K, Funakoshi N, et al. Irreparable large to massive rotator cuff tears with low-grade fatty degeneration of the infraspinatus tendon: minimum 7-year follow-up of fascia autograft patch procedure and partial repair[J]. Am J Sports Med, 2021, 49(13): 3656－3668.
[4] Lee K W, Lee G S, Yang D S, et al. Clinical outcome of arthroscopic partial repair of large to massive posterosuperior rotator cuff tears: medialization of the attachment site of the rotator cuff tendon[J]. Clin Orthop Surg, 2020, 12(3): 353－363.
[5] 黄东辉, 梅正峰, 叶辛, 等. 肱二头肌长头腱与冈上肌腱联合固定术治疗巨大肩袖损伤的疗效[J]. 温州医科大学学报, 2020, 50(3): 217－220.
[6] 尚西亮, 吕婧仪, 陈疾忤, 等. 关节镜下肱二头肌长头腱转位固定辅助替代上关节囊重建(Chinese Way)修补巨大及不可修复肩袖撕裂的临床疗效[J]. 中国运动医学杂志, 2019, 38(8): 652－657.
[7] Kim Y S, Lee H J, Park I, et al. Arthroscopic in situ superior capsular reconstruction using the long head of the biceps tendon[J]. Arthrosc Tech, 2018, 7(2): e97-e103.
[8] Roy J S, Macdermid J C, Woodhouse L J. Measuring shoulder function: a systematic review of four questionnaires[J]. Arthritis Rheum, 2009, 61(5): 623－632.
[9] Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. End-result study of factors influencing reconstruction[J]. J Bone Joint Surg Am, 1986, 68(8): 1136－1144.
[10] Shah N S, Suriel Peguero E, Umeda Y, et al. Long-term outcomes of massive rotator cuff tear repair: a systematic review[J]. HSS J, 2022, 18(1): 130－137.
[11] 任世祥, 张博, 马德思, 等. 反式全肩关节置换术治疗肩袖关节病患者的早期临床疗效[J]. 中华外科杂志, 2019, 57(2): 124－128.
[12] Park I, Lee H J, Choi Y H, et al. Arthroscopic repair of large to massive rotator cuff tears in patients younger than 60 years[J]. J Orthop Sci, 2020, 25(1): 104－109.
[13] 朱以明, 姜春岩, 鲁谊, 等. 关节镜下修复巨大肩袖损伤的临床研究[J]. 中华骨科杂志, 2017, 37(21): 1318－1325.
[14] Chen R E, Bakhsh W R, Lipof J S, et al. Rotator cuff anterior cable reconstruction with long head of biceps tendon autograft[J]. Arthrosc Tech, 2020, 9(6): e711－e715.
[15] Cho N S, Yi J W, Rhee Y G. Arthroscopic biceps augmentation for avoiding undue tension in repair of massive rotator cuff tears[J]. Arthroscopy, 2009, 25(2): 183－191.
[16] 余电柏, 韦积华, 蓝常贡, 等. 关节镜下 “Chinese way” 两种术式修补巨大及不可修复肩袖撕裂的临床研究[J]. 微创医学, 2021, 16(5): 624－629.
[17] Neer C S 2nd, Craig E V, Fukuda H. Cuff-tear arthropathy[J]. J Bone Joint Surg Am, 1983, 65(9): 1232－1244.
[18] Hochreiter B, Hasler A, Hasler J, et al. Factors influencing functional internal rotation after reverse total shoulder arthroplasty[J]. JSES Int, 2021, 5(4): 679－687.
[19] Besnard M, Freychet B, Clechet J, et al. Partial and complete repairs of massive rotator cuff tears maintain similar long-term improvements in clinical scores[J]. Knee Surg Sports Traumatol Arthrosc, 2021, 29(1): 181－191.
[20] 周可, 陆伟, 王大平, 等. 大型及巨大肩袖撕裂的肩关节镜下治疗[J]. 中华创伤骨科杂志, 2010, 12(11): 1010－1013.
[21] Malahias M A, Kostretzis L, Chronopoulos E, et al. Arthroscopic partial repair for massive rotator cuff tears: does it work? A systematic review[J]. Sports Med Open, 2019, 5(1): 13.
[22] Lapner P, Li A, Pollock J W, et al. A multicenter randomized controlled trial comparing single-row with double-row fixation in arthroscopic rotator cuff repair: long-term follow-up[J]. Am J Sports Med, 2021, 49(11): 3021－3029.
[23] Chung S W, oh J H, Gong H S, et al. Factors affecting rotator cuff healing after arthroscopic repair: osteoporosis as one of the independent risk factors[J]. Am J Sports Med, 2011, 39(10): 2099－2107.
[24] Lim T K, Bae K H, Choi Y S, et al. Clinical outcome and repair integrity after arthroscopic rotator cuff repair significantly improved during the surgeon's learning curve[J]. J Shoulder Elbow Surg, 2021, 30(8): 1881－1890.
[25] Takeda Y, Fujii K, Suzue N, et al. Repair tension during arthroscopic rotator cuff repair is correlated with preoperative tendon retraction and postoperative rotator cuff integrity[J]. Arthroscopy, 2021, 37(9): 2735－2742.