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• W4366238927 abstract "To evaluate the effectiveness of tendon insertion medialized repair in treatment of large-to-massive rotator cuff tears (L/MRCT).The clinical and imaging data of 46 L/MRCT patients who underwent arthroscopic insertion medialized repair between October 2015 and June 2019 were retrospectively analyzed. There were 26 males and 20 females with an average age of 57.7 years (range, 40-75 years). There were 20 cases of large rotator cuff tears and 26 cases of massive rotator cuff tears. Preoperative imaging evaluation included fatty infiltration (Goutallier grade), tendon retraction (modified Patte grade), supraspinatus tangent sign, acromiohumeral distance (AHD), and postoperative medializaiton length and tendon integrity. The clinical outcome was evaluated by visual analogue scale (VAS) score, American Society for Shoulder and Elbow Surgery (ASES) score, shoulder range of motion (including anteflexion and elevation, lateral external, and internal rotation) and anteflexion and elevation muscle strength before and after operation. The patients were divided into two groups (the intact tendon group and the re-teared group) according to the integrity of the tendon after operation. According to the medializaiton length, the patients were divided into group A (medialization length ≤10 mm) and group B (medialization length >10 mm). The clinical function and imaging indexes of the patients were compared.All patients were followed up 24-56 months, with an average of 31.8 months. At 1 year after operation, MRI showed that the medializaiton length of supraspinatus tendon was 5-15 mm, with an average of 10.26 mm, 33 cases in group A and 13 cases in group B. Eleven cases (23.91%) had re-teared, including 5 cases (45.45%) of Sugaya type Ⅳ and 6 cases (54.55%) of Sugaya type Ⅴ. At last follow-up, the VAS score, ASES score, shoulder anteflexion and elevation range of motion, lateral external rotation range of motion, and anteflexion and elevation muscle strength significantly improved when compared with those before operation ( P<0.05); there was no significant difference in internal rotation range of motion between pre- and post-operation ( P>0.05). The Goutallier grade and modified Patte grade of supraspinatus muscle in the re-teared group were significantly higher than those in the intact tendon group, and the AHD was significantly lower than that in the intact tendon group ( P<0.05). There was no significant difference in other baseline data between the two groups ( P>0.05). Except that the ASES score of the intact tendon group was significantly higher than that of the re-teared group ( P<0.05), there was no significant difference in the other postoperative clinical functional indicators between the two groups ( P>0.05). There was no significant difference in the incidence of re-tear, VAS score, ASES score, range of motion of shoulder joint, and anteflexion and elevation muscle strength between group A and group B ( P>0.05).Tendon insertion medialized repair may be useful in cases with L/MRCT, and shows good postoperative shoulder function. Neither tendon integrity nor medialization length shows apparent correlations with postoperative shoulder function.评估止点内移修复大型及巨大肩袖撕裂（large-to-massive rotator cuff tears，L/MRCT）的临床效果。.回顾分析2015年10月—2019年6月采用关节镜下止点内移修复的46例L/MRCT患者临床与影像学资料。男26例，女20例；年龄40～75岁，平均57.7岁。大型肩袖撕裂20例，巨大肩袖撕裂26例。影像学评估术前脂肪浸润（Goutallier分级）、肌腱回缩（改良Patte分级）、冈上肌切线征、肩峰肱骨头间距（acromiohumeral distance，AHD）及术后内移长度与肌腱完整性；以手术前后疼痛视觉模拟评分（VAS）、美国肩肘外科协会（ASES）评分、肩关节活动度（包括前屈上举、体侧外旋与内旋活动度）与前屈上举肌力评估临床结果。根据术后肌腱完整性将患者分为肌腱完整组与再撕裂组，根据术后内移长度将患者分为A组（内移长度≤10 mm）与B组（内移长度>10 mm），比较患者临床功能和影像学指标。.术后患者均获随访，随访时间24～56个月，平均31.8个月。术后1年MRI示冈上肌腱内移长度为5～15 mm，平均10.26 mm；A组33例，B组13例。11例（23.91%）出现再撕裂，其中Sugaya Ⅳ型5例（45.45%），Ⅴ型6例（54.55%）。末次随访时VAS评分、ASES评分及肩关节前屈上举活动度、体侧外旋活动度、前屈上举肌力均较术前显著改善（ P<0.05）；内旋活动度与术前比较差异无统计学意义（ P>0.05）。肌腱再撕裂组冈上肌Goutallier分级与改良Patte分级高于肌腱完整组，AHD小于肌腱完整组，差异有统计学意义（ P<0.05）；其他基线资料两组比较差异无统计学意义（ P>0.05）。除ASES评分肌腱完整组高于再撕裂组（ P<0.05）外，两组其余术后临床功能指标比较差异均无统计学意义（ P>0.05）。A、B组再撕裂发生情况、VAS评分、ASES评分、肩关节活动度与前屈上举肌力比较，差异均无统计学意义（ P>0.05）。.对于L/MRCT关节镜下采用止点内移修复术后能获得良好肩关节功能；术后肌腱完整性或内移长度与术后肩关节功能之间可能无显著相关性。." @default.
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• W4366238927 date "2023-04-15" @default.
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• W4366238927 title "[Clinical and radiologic outcomes after tendon insertion medialized repair of large-to-massive rotator cuff tears]." @default.
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