Саратовский научно-медицинский журнал (Sep 2018)
Evaluation results of arthroscopic reconstruction of rotator cuff using single-row anchor fixation
Abstract
The purpose was to evaluate the results of arthroscopic reconstruction of the rotator cuff of a shoulder using the single-row anchor fixation method, to evaluate the dependence of the results of treatment on the size of the rupture of the rotator cuff of the shoulder. Material and Methods. This report provides an analysis of results of surgical treatment of 84 patients with the damage of the rotator cuff of a shoulder, who underwent arthroscopic reconstruction of the rotational cuff of a shoulder using single-row anchor fixation. The size of rupture of the rotator cuff of the shoulder was measured with the use of MRI and during surgery itself. All ruptures were subdivided into small (less than 1 cm), medium (1-3 cm) and large (3-5 cm). The exclusion criteria were patients with a massive rupture of the rotator cuff of a shoulder, with retraction of the tendon to the level of the articular process of the scapula or fatty degeneration of the muscles of the short shoulder rotators. The paper presents the features of operative technique and original algorithm for postoperative rehabilitation at different stages of treatment. Evaluation of the results of treatment was performed according to the rating scale of the Constant score, ASES, UCLA. Results. The average age of the patients was 56.0±7.4 (36-71 years). Of these, 22.6% patients had a small degree of rupture of the rotator cuff of a shoulder, 50% middle and 27.4% patients had a large degree of rupture. The nearest results (up to one year) were evaluated in 5 patients, long-term results in 79 patients (more than a year). The average rating score according to the Constant score was 89,8±9,2; the average value according to the ASES scale was 83,7±17,6; the average value according to the UCLA scale was 29.3±5.9. In all other patients complete recovery was observed in the period from 6 months to a year after the operation, there was a decrease in the pain syndrome, an increase in the volume of movements, an improvement in the quality of life. Conclusion. Arthroscopic reconstruction of the rotator cuff of a shoulder using the method of single-row anchor fixation, if necessary, with the help of seams which reapproximate the edges of the rupture, and with the help of the accompanying procedures, provides good results. Reduction in pain, increase in movement and in muscle strength in the arm were noted in all patients, regardless of the size of the damage to the rotator cuff of the shoulder. The rehabilitative protocol used ensures the creation of favorable conditions for engraftment of the restored tendon and, at the same time, provides prevention of the development of the stiffness of the shoulder joint.
