Comparison of the Functional Outcomes of Arthroscopic Debridement and Repair of Bursal-side Partial-thickness Rotator Cuff Tears

F. Can
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Abstract

Background: To compare the clinical and functional scores of arthroscopic debridement and repair (conversion to full thickness) surgeries in patients with bursal-side partial-thickness rotator cuff tears (BPTRCT). Materials and Methods: A single-center retrospective study was conducted to compare the arthroscopic debride-ment and arthroscopic repair for BPTRCT performed between March 2017 and September 2021. Arthroscopic debridement patients were grouped as Group 1 and the repair group as Group 2. A total of 98 patients with an average age of 57.5 years (range 29-83 years), including 41 male and 57 female patients, met the inclusion criteria. VAS (Visual Analogue Scale) and UCLA (University of California Los Angeles) shoulder scores applied in the preopera-tive period and in the 12th month of the postoperative clinical follow-ups were evaluated. In addition to the pre-operative and postoperative comparison of both scores, their improvement of these scores was also compared. Results: The mean age of the repair group and the debridement group was 64.4 ±11.02 and 52.6 ±11.24, respective-ly. No significant difference between the two groups was observed in terms of demographic characteristics (p˃0.05). The mean operation time was 91.46 ±16.44 min in the repair group and 49.82 ±13.46 min in the debridement group. The VAS score dramatically improved, from preoperative 5.10±1.23 to postoperative 3.68±1.33 points in the deb-ridement group and from preoperative 5.17±1.35 to postoperative 3.58±1.16 points in the repair group. The two groups had no statistically significant difference in postoperative VAS scores (p=0.991). Preoperative and postopera-tive VAS score improvement was also compared between the groups, however, there was also no statistically signifi-cant difference in terms of VAS score changes (p=0.132). The UCLA scores also dramatically improved, from pre-operative 17.14±4.19 to postoperative 24.57±5.04 points in the debridement group and from preoperative 17.46±5.05 to postoperative 25.48±5.61 points in the repair group. No statistically significant difference was ob-served between the two groups in terms of postoperative UCLA scores (p=0.361). In the postoperative first-year follow-up, no re-tears were observed either in the debridement or in the repair group. Conclusions: Both arthroscopic debridement and arthroscopic repair surgeries provide clinically comparable suc-cessful results and high satisfaction for patients with bursal-side rotator cuff tears. No statistically significant differ-ence was observed between these two methods. Easier early postoperative rehabilitation seems to be the main advantage of the debridement method.
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关节镜下清创与修复法囊侧部分厚度肩袖撕裂的功能效果比较
背景:比较关节镜下法囊侧部分厚度肩袖撕裂(BPTRCT)患者的清创和修复(转换为全层)手术的临床和功能评分。材料和方法:我们进行了一项单中心回顾性研究,比较2017年3月至2021年9月期间进行的BPTRCT关节镜清创和关节镜修复。关节镜下清创组为1组,修复组为2组。共有98例患者符合纳入标准,平均年龄57.5岁(29-83岁),其中男性41例,女性57例。对术前和术后12个月临床随访时应用的VAS(视觉模拟量表)和UCLA(加州大学洛杉矶分校)肩部评分进行评估。除了术前和术后两种评分的比较外,还比较了两种评分的改善情况。结果:修复组和清创组的平均年龄分别为64.4±11.02岁和52.6±11.24岁。两组患者人口学特征差异无统计学意义(p > 0.05)。修复组平均手术时间91.46±16.44 min,清创组平均手术时间49.82±13.46 min。VAS评分由术前5.10±1.23分提高到术后3.68±1.33分,修复组由术前5.17±1.35分提高到术后3.58±1.16分。两组术后VAS评分差异无统计学意义(p=0.991)。比较两组患者术前、术后VAS评分改善情况,但VAS评分变化差异无统计学意义(p=0.132)。UCLA评分也显著提高,清创组从术前17.14±4.19分提高到术后24.57±5.04分,修复组从术前17.46±5.05分提高到术后25.48±5.61分。两组术后UCLA评分差异无统计学意义(p=0.361)。在术后1年随访中,无论是清创组还是修复组均未观察到再次撕裂。结论:关节镜下清创和关节镜下修复手术均可为法囊侧肩袖撕裂患者提供临床相似的成功结果和高满意度。两种方法比较差异无统计学意义。较容易的术后早期康复似乎是清创方法的主要优点。
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