REVERSED ARTHROSC OPIC SUBACROMIAL DEC OMPRESSION FOR TREATMENT OF ROTATOR CUFF TEARS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SUNChao ,  PANZhaoxun , YANGXiaoming , DUBencai

Department of Joint Surgery, the 89th Hospital of Chinese PLA, Weifang Shandong, 261021, P. R. China;

Corresponding?author：

PANZhaoxun, Email: guke89@126.com

Keywords：

Arthroscopy; Reversed subacromial decompression; Rotator cuff tear; Greater tuberosity

DOI：

10.7507/1002-1892.20160191

Video：

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Objective To investigate the effectiveness of reversed arthroscopic subacromial decompression in the treatment of rotator cuff tears. Methods Between November 2012 and January 2015, 53 patients with rotator cuff tears were treated with reversed arthroscopic subacromial decompression and rotator cuff repair. Of 53 patients, 38 were male and 15 were female, with the age of 47-61 years (mean, 53.4 years). The injury was caused by falling in 36 cases and other in 17 cases without an obvious history of trauma. All patients had shoulder pain and limited shoulder movement before operation. Visual analogue scale (VAS) was 6.4±0.9, and University of California at Los Angeles (UCLA) score was 16.3±1.9. MRI showed that distal supraspinatus tear was observed in 41 cases and distal infraspinatus tear in 12 cases; partial-thickness rotator cuff tear was observed in 9 cases and full-thickness tear in 44 cases. And the tear size was from 1 to 3 cm (mean, 1.9 cm). Combined injuries included tendinitis of long head of biceps brachii in 31 cases, Bankart lesion in 5 cases, and superior labrum anterior and posterior lesion in 2 cases. Results Incision healed by first intention in all patients; no infection or nerve injury occurred. Forty-nine cases were followed up from 12 to 35 months (mean, 22.8 months). After operation, shoulder pain relief was achieved in 42 cases; 7 cases had anterior shoulder pain at 3 months after operation, which was relieved after symptomatic treatment. At last follow-up, VAS score was significantly decreased to 0.5±0.6 (t=40.565, P=0.000). UCLA score was significantly increased to 33.8±1.7 (t=-79.799, P=0.000). The results were excellent in 42 cases, good in 6 cases, and fair in 1 case; the excellent and good rate was 98.0%. Conclusion Reversed arthroscopic subacromial decompression can avoid coracoacromial arch injury and achieve good recovery of joint function, so it can be used in rotator cuff tears procedure.

Citation： SUNChao, PANZhaoxun, YANGXiaoming, DUBencai. REVERSED ARTHROSC OPIC SUBACROMIAL DEC OMPRESSION FOR TREATMENT OF ROTATOR CUFF TEARS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(8): 943-946. doi: 10.7507/1002-1892.20160191 Copy

1.	Herrmann SJ, Izadpanah K, Südkamp NP, et al. Tears of the rotator cuff. Causes-diagnosis-treatment. Acta Chir Orthop Traumatol Cech, 2014, 81(4):256-266.
2.	Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder:a preliminary report. J Bone Joint Surg (Am), 1972, 54(1):41-50.
3.	張春剛, 王衛明, 趙德偉, 等.肩袖部分撕裂的關節鏡治療.中國骨與關節損傷雜志, 2010, 25(7):586-588.
4.	李小飛, 謝文瑾, 盛路新.肩關節鏡下肩袖修復術治療肩袖損傷的臨床效果觀察.山東醫藥, 2015, 55(37):90-91.
5.	黃成龍, 潘界恩, 蔡震海, 等.關節鏡下縫線橋技術治療老年創傷性肩關節脫位合并肩袖損傷的療效評價.中國內鏡雜志, 2016, 22(6):35-39.
6.	Fenlin JM Jr, Chase JM, Rushton SA, et al. Tuberoplasty:creation of an acromiohumeral articulation-a treatment option for massive, irreparable rotator cuff tears. J Shoulder Elbow Surg, 2002, 11(2): 136-142.
7.	Abrams GD, Gupta AK, Hussey KE, et al. Arthroscopic repair of full-thickness rotator cuff tears with and without acromioplasty: randomized prospective trial with 2-year follow-up. Am J Sports Med, 2014, 42(6):1296-1303.
8.	Filippo F, Alan GZ, Bruno I, et al. Is acromioplasty necessary in the setting of full-thickness rotator cuff tears? A systematic review. J Orthopaed Traumatol, 2015, 16(3):167-174.
9.	Mihata T, McGarry MH, Kahn T, et al. Biomechanical effects of acromioplasty on superior capsule reconstruction for irreparable supraspinatus tendon tears. Am J Sports Med, 2016, 44(1):191-197.
10.	王勇, 徐友高.關節鏡下肩峰成形術治療肩峰撞擊征.中國骨與關節損傷雜志, 2014, 29(11):1157-1158.
11.	劉曉潭, 田林強, 賈金嶺, 等.關節鏡下改良前肩峰成形術治療肩峰撞擊綜合征的療效觀察.中國內鏡雜志, 2015, 21(2):203-206.
12.	Park SE, Panchal K, Jeong JJ, et al. Intratendinous rotator cuff tears:prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm followup. Am J Sports Med, 2015, 43(2):415-422.
13.	劉平, 敖英芳.關節鏡下縫合橋技術與雙排縫合技術治療肩袖部分損傷21例回顧性研究.中國運動醫學雜志, 2016, 35(2):137-140.
14.	Kim KC, Shin HD, Cha SM, et al. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear:articular-versus bursal-side partial tears. Am J Sports Med, 2014, 42(2):451-456.
15.	Shin SJ, Kook SH, Rao N, et al. Clinical outcomes of modified Mason-Allen single-row repair for bursal-sided partial-thickness rotator cuff tears:comparison with the double-row suture-bridge technique. Am J Sports Med, 2015, 43(8):1976-1982.
16.	Xiao J, Cui G. Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears. J Shoulder Elbow Surg, 2015, 24(2):e41-46.
17.	莊澤, 盧華定, 陳郁鮮, 等.肩袖損傷后單排與雙排縫合方法比較的Meta分析.中國組織工程研究, 2014, 18(29):4742-4751.
18.	黃祖輝, 譚志超, 李征, 等.肩關節鏡下雙排縫線橋技術治療肩袖損傷.深圳中西醫結合雜志, 2015, 25(20):100-101.
19.	李小飛, 謝文瑾, 盛路新.老年退變性肩袖損傷的肩關節鏡治療.實用骨科雜志, 2016, 22(2):107-110.

1. Herrmann SJ, Izadpanah K, Südkamp NP, et al. Tears of the rotator cuff. Causes-diagnosis-treatment. Acta Chir Orthop Traumatol Cech, 2014, 81(4):256-266.
2. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder:a preliminary report. J Bone Joint Surg (Am), 1972, 54(1):41-50.
3. 張春剛, 王衛明, 趙德偉, 等.肩袖部分撕裂的關節鏡治療.中國骨與關節損傷雜志, 2010, 25(7):586-588.
4. 李小飛, 謝文瑾, 盛路新.肩關節鏡下肩袖修復術治療肩袖損傷的臨床效果觀察.山東醫藥, 2015, 55(37):90-91.
5. 黃成龍, 潘界恩, 蔡震海, 等.關節鏡下縫線橋技術治療老年創傷性肩關節脫位合并肩袖損傷的療效評價.中國內鏡雜志, 2016, 22(6):35-39.
6. Fenlin JM Jr, Chase JM, Rushton SA, et al. Tuberoplasty:creation of an acromiohumeral articulation-a treatment option for massive, irreparable rotator cuff tears. J Shoulder Elbow Surg, 2002, 11(2): 136-142.
7. Abrams GD, Gupta AK, Hussey KE, et al. Arthroscopic repair of full-thickness rotator cuff tears with and without acromioplasty: randomized prospective trial with 2-year follow-up. Am J Sports Med, 2014, 42(6):1296-1303.
8. Filippo F, Alan GZ, Bruno I, et al. Is acromioplasty necessary in the setting of full-thickness rotator cuff tears? A systematic review. J Orthopaed Traumatol, 2015, 16(3):167-174.
9. Mihata T, McGarry MH, Kahn T, et al. Biomechanical effects of acromioplasty on superior capsule reconstruction for irreparable supraspinatus tendon tears. Am J Sports Med, 2016, 44(1):191-197.
10. 王勇, 徐友高.關節鏡下肩峰成形術治療肩峰撞擊征.中國骨與關節損傷雜志, 2014, 29(11):1157-1158.
11. 劉曉潭, 田林強, 賈金嶺, 等.關節鏡下改良前肩峰成形術治療肩峰撞擊綜合征的療效觀察.中國內鏡雜志, 2015, 21(2):203-206.
12. Park SE, Panchal K, Jeong JJ, et al. Intratendinous rotator cuff tears:prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm followup. Am J Sports Med, 2015, 43(2):415-422.
13. 劉平, 敖英芳.關節鏡下縫合橋技術與雙排縫合技術治療肩袖部分損傷21例回顧性研究.中國運動醫學雜志, 2016, 35(2):137-140.
14. Kim KC, Shin HD, Cha SM, et al. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear:articular-versus bursal-side partial tears. Am J Sports Med, 2014, 42(2):451-456.
15. Shin SJ, Kook SH, Rao N, et al. Clinical outcomes of modified Mason-Allen single-row repair for bursal-sided partial-thickness rotator cuff tears:comparison with the double-row suture-bridge technique. Am J Sports Med, 2015, 43(8):1976-1982.
16. Xiao J, Cui G. Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears. J Shoulder Elbow Surg, 2015, 24(2):e41-46.
17. 莊澤, 盧華定, 陳郁鮮, 等.肩袖損傷后單排與雙排縫合方法比較的Meta分析.中國組織工程研究, 2014, 18(29):4742-4751.
18. 黃祖輝, 譚志超, 李征, 等.肩關節鏡下雙排縫線橋技術治療肩袖損傷.深圳中西醫結合雜志, 2015, 25(20):100-101.
19. 李小飛, 謝文瑾, 盛路新.老年退變性肩袖損傷的肩關節鏡治療.實用骨科雜志, 2016, 22(2):107-110.

Chinese Journal of Reparative and Reconstructive Surgery

REVERSED ARTHROSC OPIC SUBACROMIAL DEC OMPRESSION FOR TREATMENT OF ROTATOR CUFF TEARS

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