Transitioning to Arthroscopic Rotator Cuff Repair: The Pros and Cons

K. Yamaguchi, W. Levine, G. Marra, L. Galatz, S. Klepps, E. Flatow
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引用次数: 128

Abstract

There has been much recent enthusiasm regarding complete arthroscopic rotator cuff repair, and it is becoming apparent that, for many, this newer technique may be a preferable alternative to the more traditional mini-open rotator cuff repair. Several short-term studies have demonstrated that complete arthroscopic repair has excellent results comparable with those of mini-open repair, which is also an excellent technique. The choice of which procedure may be better for an individual patient or surgeon can be based on a variety of considerations, including the patient's expectations, the pathoanatomy of the cuff, and the surgical experience of the surgeon. The relative merits and disadvantages of arthroscopic rotator cuff repair are discussed on the basis of those considerations. When a surgeon is deciding which procedure to perform, it is important that the basic principles of rotator cuff repair not be compromised and that he or she perform the procedure that is most reproducible given his or her level of experience; however, for those who are now utilizing miniopen repair, arthroscopic repair may have important advantages and may be worth pursuing in the future. If a surgeon chooses to obtain the skills necessary to perform a complete arthroscopic repair, performance of the mini-open procedure offers an excellent opportunity to make an orderly transition.
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过渡到关节镜下肩袖修复:利与弊
最近对全关节镜下肩袖修复术有了很大的热情,并且越来越明显,对许多人来说,这种新技术可能是更传统的迷你开放式肩袖修复术的更好选择。几项短期研究表明,完全关节镜修复具有与小开口修复相当的良好效果,小开口修复也是一种优秀的技术。对于单个患者或外科医生来说,选择哪种手术可能更好,可以基于多种考虑因素,包括患者的期望、袖带的病理解剖和外科医生的手术经验。在此基础上讨论了关节镜下肩袖修复术的优缺点。当外科医生决定采用哪一种手术时,重要的是不要损害肩袖修复的基本原则,并且根据他或她的经验水平,他或她采用最具可重复性的手术;然而,对于那些目前正在使用小开口修复的患者,关节镜修复可能具有重要的优势,并且可能值得将来继续研究。如果外科医生选择获得进行完整关节镜修复所需的技能,那么小切口手术的实施为有序过渡提供了绝佳的机会。
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