Chalmers Peter N, Tashjian Robert Z
Division of Sports Medicine, Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
Curr Rev Musculoskelet Med. 2020 Oct;13(5):561-571. doi: 10.1007/s12178-020-09658-4.
Rotator cuff repair has excellent outcomes for many patients but continues to be suboptimal for large, retracted tears, and revision procedures. In these situations, patch augmentation may be considered in order to improve healing. The purpose of this article is to review the history, graft options, indications, surgical technique, outcomes, and complications associated with arthroscopic patch augmentation for rotator cuff repair.
Patch augmentation has been shown in several studies to improve healing rates. After multiple investigations into different materials available for patch augmentation, acellular dermal allograft seems to be the graft with the best scientific support. While multiple techniques have been presented, few studies have compared their performance. While the arthroscopic technique for patch augmentation can be challenging, we present a systematic approach to this procedure with the potential to reliably and predictably perform patch augmentation. This technique is a valuable tool for surgeons that treat rotator cuff pathology.
肩袖修复对许多患者具有良好的效果,但对于大型、回缩性撕裂以及翻修手术而言,效果仍不尽人意。在这些情况下,可考虑使用补片增强术来促进愈合。本文旨在回顾与关节镜下补片增强术用于肩袖修复相关的历史、移植物选择、适应症、手术技术、疗效及并发症。
多项研究表明补片增强术可提高愈合率。在对多种可用于补片增强术的材料进行多次研究后,脱细胞真皮同种异体移植物似乎是最具科学依据的移植物。虽然已提出多种技术,但很少有研究对它们的性能进行比较。尽管关节镜下补片增强术具有挑战性,但我们提供了一种系统的手术方法,有可能可靠且可预测地实施补片增强术。该技术是治疗肩袖病变的外科医生的一项宝贵工具。