{"title":"大面积肩袖撕裂的治疗必须根据患者的具体情况而定:桥接修复可对无法修复的撕裂进行低张力修复。","authors":"Michael H Amini","doi":"10.1016/j.arthro.2024.08.034","DOIUrl":null,"url":null,"abstract":"<p><p>Treatment options for large and massive rotator cuff tears, in the setting of failed conservative treatment, include debridement, isolated biceps tenotomy or tenodesis, primary repair, partial repair, subacromial spacer, superior capsular reconstruction, biologic tuberoplasty, bridging reconstruction, tendon transfers, reverse shoulder arthroplasty, and others. Each performs well under optimal indications. Bridging reconstruction performs best in the setting of an irreparable tear of the superior-posterior rotator cuff, with an intact or reparable subscapularis, particularly if the patient has reasonably preserved function/range of motion preoperatively. Advantages of bridging reconstruction include lower-tension repair, which may be superior to partial primary repair with incomplete footprint coverage in the case of irreparable tears.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment of large and massive rotator cuff tear must be based on individual patient indications: Bridging Repair Allows Low Tension Repair of Irreparable Tears.\",\"authors\":\"Michael H Amini\",\"doi\":\"10.1016/j.arthro.2024.08.034\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Treatment options for large and massive rotator cuff tears, in the setting of failed conservative treatment, include debridement, isolated biceps tenotomy or tenodesis, primary repair, partial repair, subacromial spacer, superior capsular reconstruction, biologic tuberoplasty, bridging reconstruction, tendon transfers, reverse shoulder arthroplasty, and others. Each performs well under optimal indications. Bridging reconstruction performs best in the setting of an irreparable tear of the superior-posterior rotator cuff, with an intact or reparable subscapularis, particularly if the patient has reasonably preserved function/range of motion preoperatively. Advantages of bridging reconstruction include lower-tension repair, which may be superior to partial primary repair with incomplete footprint coverage in the case of irreparable tears.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2024.08.034\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.08.034","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Treatment of large and massive rotator cuff tear must be based on individual patient indications: Bridging Repair Allows Low Tension Repair of Irreparable Tears.
Treatment options for large and massive rotator cuff tears, in the setting of failed conservative treatment, include debridement, isolated biceps tenotomy or tenodesis, primary repair, partial repair, subacromial spacer, superior capsular reconstruction, biologic tuberoplasty, bridging reconstruction, tendon transfers, reverse shoulder arthroplasty, and others. Each performs well under optimal indications. Bridging reconstruction performs best in the setting of an irreparable tear of the superior-posterior rotator cuff, with an intact or reparable subscapularis, particularly if the patient has reasonably preserved function/range of motion preoperatively. Advantages of bridging reconstruction include lower-tension repair, which may be superior to partial primary repair with incomplete footprint coverage in the case of irreparable tears.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.