肩袖部分撕裂的诊疗进展
摘要
肩袖部分撕裂是导致肩关节疼痛和功能受限的主要疾病,发病率极高。其病因可分为内在因素和外在因素。临床上,通过询问病史、查体及影像学检查可以确诊此疾病。肩袖部分撕裂的治疗方法主要包括保守治疗、手术治疗及生物治疗,但是其最佳治疗方法尚存在一定争议。本文就肩袖部分撕裂的发病率、病因、诊断和治疗等方面进行综述。
引文
[1]LOHR J F,UHTHOFF H K.Epidemiology and pathophysiology of rotator cuff tears[J].Orthopade,2007,36(9):788-795.
[2]FUKUDA H.Partial-thickness rotator cuff tears:a modern view on Codman’s classic[J].Journal of Shoulder and Elbow Surgery,2000,9(2):163-168.
[3]SHER J S,URIBE J W,POSADA A,et al.Abnormal findings on magnetic resonance images of asymptomatic shoulders[J].The Journal of Bone and Joint Surgery:American Volume,1995,77(1):10-15.
[4]MILGROM C,SCHAFFLER M,GILBERT S,et al.Rotatorcuff changes in asymptomatic adults.The effect of age,hand dominance and gender[J].The Journal of Bone and Joint Surgery:British Volume,1995,77(2):296-298.
[5]HASHIMOTO T,NOBUHARA K,HAMADA T.Pathologic evidence of degeneration as a primary cause of rotator cuff tear[J].Clinical Orthopaedics and Related Research,2003,415(415):111-120.
[6]NHO S J,YADAV H,SHINDLE M K.Rotator cuff degeneration:etiology and pathogenesis[J].American Journal of Sports Medicine,2008,36(5):987-993.
[7]HALDER A M,O’DRISCOLL S W,HEERS G,et al.Biomechanical comparison of effects of supraspinatus tendon detachments,tendon defects,and muscle retractions[J].Journal of Bone and Joint Surgery:American Volume,2002,84A(5):780-785.
[8]SANO H,ISHII H,YEADON A,et al.Degeneration at the insertion weakens the tensile strength of the supraspinatus tendon:a comparative mechanical and histologic study of the bone-tendon complex[J].J Orthop Res Society,2010,15(5):719-726.
[9]BEY M J,RAMSEY M L,SOSLOWSKY L J.Intratendinous strain fields of the supraspinatus tendon:effect of a surgically created articular-surface rotator cuff tear[J].Journal of Shoulder and Elbow Surgery,2002,11(6):562-569.
[10]LO I K,BURKHART S S.Transtendon arthroscopic repair of partial-thickness,articular surface tears of the rotator cuff[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,2004,20(2):214-220.
[11]MALL N A,KIM H M,KEENER J D,et al.Symptomatic progression of asymptomatic rotator cuff tears:aprospective study of clinical and sonographic variables[J].The Journal of Bone and Joint Surgery:American Volume,2010,92(16):2623-2633.
[12]YAMANAKA K,MATSUMOTO T.The joint side tear of the rotator cuff.A followup study by arthrography[J].Clinical Orthopaedics and Related Research,1994(304):68-73.
[13]FUKUDA H,HAMADA K,NAKAJIMA T,et al.Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections[J].Clinical Orthopaedics,1994(304):60-67.
[14]LIN A,GASBARRO G,SAKR M.Clinical applications of ultrasonography in the shoulder and elbow[J].Journal of the American Academy of Orthopaedic Surgeons,2018,26(9):303-312.
[15]DAY M,MCCORMACK R A,NAYYAR S,et al.Physician training ultrasound and accuracy of diagnosis in rotator cuff tears[J].Bulletin of the Hospital for Joint Diseases,2016,74(3):207-211.
[16]VAN DYCK P,GIELEN J L,VERYSER J,et al.Tears of the supraspinatus tendon:assessment with indirect magnetic resonance arthrography in 67patients with arthroscopic correlation[J].Acta Radiologica,2009,50(9):1057-1063.
[17]SHARMA G,BHANDARY S,Khandige G,et al.MR imaging of rotator cuff tears:correlation with arthroscopy[J].Journal of Clinical and Diagnostic Research:JCDR,2017,11(5):24-27.
[18]DE JESUS J O,PARKER L,FRANGOS A J,et al.Accuracy of MRI,MR arthrography,and ultrasound in the diagnosis of rotator cuff tears:a meta-analysis[J].AJR:American Journal of Roentgenology,2009,192(6):1701-1707.
[19]FINNAN R P,CROSBY L A.Partial-thickness rotator cuff tears[J].Journal of Shoulder&Elbow Surgery,2010,19(4):609-616.
[20]FUKUDA H,MIKASA M,YAMANAKA K.Incomplete thickness rotator cuff tears diagnosed by subacromial bursography[J].Clinical Orthopaedics&Related Research,1987(223):51-58.
[21]SNYDER S J,PACHELLI A F,PIZZO W D,et al.Partial thickness rotator cuff tears:results of arthroscopic treatment[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,1991,7(1):1-7.
[22]LO I,GONZALEZ D M,BURKHART S S.The bubble sign:an arthroscopic indicator of an intratendinous rotator cuff tear[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,2002,18(9):1029-1033.
[23]ELLMAN H.Diagnosis and treatment of incomplete rotator cuff tears[J].Clinical Orthopaedics and Related Research,1990,254(254):64-74.
[24]YAMAMOTO N,MINETA M,KAWAKAMI J,et al.Risk factors for tear progression in symptomatic rotator cuff tears a prospective study of 174shoulders[J].American Journal of Sports Medicine,2017,45(11):2524-2531.
[25]SHIN K M.Partial-thickness rotator cuff tears[J].Korean Journal of Pain,2011,24(2):69-73.
[26]RUDZKI J R,SHAFFER B.New approaches to diagnosis and arthroscopic management of partial-thickness cuff tears[J].Clinics in Sports Medicine,2008,27(4):691-717.
[27]KONG B Y,CHO M,LEE H R,et al.Structural evolution of nonoperatively treated high-grade partial-thickness tears of the supraspinatus tendon[J].American Journal of Sports Medicine,2018,46(1):79-86.
[28]LO I K,DENKERS M R,MORE K D,et al.Partial-thickness rotator cuff tears:clinical and imaging outcomes and prognostic factors of successful nonoperative treatment[J].Open Access Journal of Sports Medicine,2018,9(18):191-197.
[29]KIM Y S,LEE H J,KIM J H,et al.When should we repair partial-thickness rotator cuff tears?Outcome comparison between immediate surgical repair versus delayed repair after 6-month period of nonsurgical treatment[J].American Journal of Sports Medicine,2018,46(5):1091-1096.
[30]YANG S,PARK H S,FLORES S,et al.Biomechanical analysis of bursal-sided partial thickness rotator cuff tears[J].Journal of Shoulder and Elbow Surgery,2009,18(3):379-385.
[31]PARK J Y,YOO M J,KIM M H.Comparison of surgical outcome between bursal and articular partial thickness rotator cuff tears[J].Orthopedics,2003,26(4):387-390.
[32]CORDASCO F A,BACKER M,CRAIG E V,et al.The partial-thickness rotator cuff tear:is acromioplasty without repair sufficient[J]?American Journal of Sports Medicine,2002,30(2):257-260.
[33]XIAO Jian,CUI Guoqing.Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears[J].Journal of Shoulder and Elbow Surgery,2015,24(2):E41-E46.
[34]FUKUDA H,HAMADA K,NAKAJIMA T,et al.Partialthickness tears of the rotator cuff[J].Journal of Bone&Joint Surgery British Volume,2003,85(1):3-11.
[35]OZAKI J,FUJIMOTO S,NAKAGAWA Y,et al.Tears of the rotar cuff of the shoulder associated with pathological changes in the acromion:a study in cadavera[J].Journal of Bone and Joint Surgery-American Volume,1988,70(8):1224-1230.
[36]KIM S J,KIM S H,LIM S H,et al.Use of magnetic resonance arthrography to compare clinical features and structural integrity after arthroscopic repair of bursal versus articular side partial-thickness rotator cuff tears[J].American Journal of Sports Medicine,2013,41(9):2041-2047.
[37]PETERS K S,LAM P H,MURRELL G A.Repair of partialthickness rotator cuff tears:a biomechanical analysis of footprint contact pressure and strength in an ovine model[J].Arthroscopy-the Journal of Arthroscopic and Related Surgery,2010,26(7):877-884.
[38]CASTRICINI R,PANFOLI N,NITTOLI R,et al.Transtendon arthroscopic repair of partial-thickness,articular surface tears of the supraspinatus:results at 2years[J].Musculoskeletal Surgery,2009,93(1):49-54.
[39]OSTI L,BUDA M,ANDREOTTI M,et al.Transtendon repair in partial articular supraspinatus tendon tear[J].British Medical Bulletin,2017,123(1):19-34.
[40]AYDIN N,KARAISMAILOGLU B.High-grade bursal-side partial rotator cuff tears:comparison of mid-and long-term results following arthroscopic repair after conversion to a fullthickness tear[J].Journal of Orthopaedic Surgery and Research,2017,12(1):118.
[41]IYENGAR J J,PORAT S,BURNETT K R,et al.Magnetic resonance imaging tendon integrity assessment after arthroscopic partial-thickness rotator cuff repair[J].Arthroscopythe Journal of Arthroscopic and Related Surgery,2011,27(3):306-313.
[42]GERELI A,KOCAOGLU B,ULKU T K,et al.Completion repair exhibits increased healing characteristics compared with in situ repair of partial thickness bursal rotator cuff tears[J].Knee Surgery Sports Traumatology Arthroscopy,2018,26(8):2498-2504.
[43]SHIN S J.A comparison of 2repair techniques for partialthickness articular-sided rotator cuff tears[J].Arthroscopythe Journal of Arthroscopic and Related Surgery,2012,28(1):25-33.
[44]CHARLES M D,CHRISTIAN D R,COLE B J.The role of biologic therapy in rotator cuff tears and repairs[J].Current Reviews in Musculoskeletal Medicine,2018,11(1):150-161.
[45]YANG W Y,HAN Y H,CAO X W,et al.Platelet-rich plasma as a treatment for plantar fasciitis:a meta-analysis of randomized controlled trials[J].Medicine,2017,96(44):e8475.
[46]MILLER L E,PARRISH W R,ROIDES B,et al.Efficacy of platelet-rich plasma injections for symptomatic tendinopathy:systematic review and meta-analysis of randomised injectioncontrolled trials[J].BMJ Open Sport Exerc Med,2017,3(1):e237.
[47]SHAMS A,EL-SAYED M,GAMAL O,et al.Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears[J].European Journal of Orthopaedic Surgery&Traumatology,2016,26(8):1-6.
[48]D’AMBROSI R,PALUMBO F,PARONZINI A,et al.Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears:a randomized clinical trial[J].Musculoskeletal Surgery,2016,100(1):25-32.
[49]HOLTBY R,CHRISTAKIS M,MAMAN E,et al.Impact of platelet-rich plasma on arthroscopic repair of small-to MediumSized rotator cuff tears:a randomized controlled trial[J].Orthopaedic Journal of Sports Medicine,2016,4(9):1807713019.
[50]PATRICK V,PATRICK S,MATTHEW P,et al.Plateletrich plasma reduces retear rates after arthroscopic repair of small-and medium-sized rotator cuff tears but is not cost-effective[J].American Journal of Sports Medicine,2015,43(12):3071-3076.
[2]FUKUDA H.Partial-thickness rotator cuff tears:a modern view on Codman’s classic[J].Journal of Shoulder and Elbow Surgery,2000,9(2):163-168.
[3]SHER J S,URIBE J W,POSADA A,et al.Abnormal findings on magnetic resonance images of asymptomatic shoulders[J].The Journal of Bone and Joint Surgery:American Volume,1995,77(1):10-15.
[4]MILGROM C,SCHAFFLER M,GILBERT S,et al.Rotatorcuff changes in asymptomatic adults.The effect of age,hand dominance and gender[J].The Journal of Bone and Joint Surgery:British Volume,1995,77(2):296-298.
[5]HASHIMOTO T,NOBUHARA K,HAMADA T.Pathologic evidence of degeneration as a primary cause of rotator cuff tear[J].Clinical Orthopaedics and Related Research,2003,415(415):111-120.
[6]NHO S J,YADAV H,SHINDLE M K.Rotator cuff degeneration:etiology and pathogenesis[J].American Journal of Sports Medicine,2008,36(5):987-993.
[7]HALDER A M,O’DRISCOLL S W,HEERS G,et al.Biomechanical comparison of effects of supraspinatus tendon detachments,tendon defects,and muscle retractions[J].Journal of Bone and Joint Surgery:American Volume,2002,84A(5):780-785.
[8]SANO H,ISHII H,YEADON A,et al.Degeneration at the insertion weakens the tensile strength of the supraspinatus tendon:a comparative mechanical and histologic study of the bone-tendon complex[J].J Orthop Res Society,2010,15(5):719-726.
[9]BEY M J,RAMSEY M L,SOSLOWSKY L J.Intratendinous strain fields of the supraspinatus tendon:effect of a surgically created articular-surface rotator cuff tear[J].Journal of Shoulder and Elbow Surgery,2002,11(6):562-569.
[10]LO I K,BURKHART S S.Transtendon arthroscopic repair of partial-thickness,articular surface tears of the rotator cuff[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,2004,20(2):214-220.
[11]MALL N A,KIM H M,KEENER J D,et al.Symptomatic progression of asymptomatic rotator cuff tears:aprospective study of clinical and sonographic variables[J].The Journal of Bone and Joint Surgery:American Volume,2010,92(16):2623-2633.
[12]YAMANAKA K,MATSUMOTO T.The joint side tear of the rotator cuff.A followup study by arthrography[J].Clinical Orthopaedics and Related Research,1994(304):68-73.
[13]FUKUDA H,HAMADA K,NAKAJIMA T,et al.Pathology and pathogenesis of the intratendinous tearing of the rotator cuff viewed from en bloc histologic sections[J].Clinical Orthopaedics,1994(304):60-67.
[14]LIN A,GASBARRO G,SAKR M.Clinical applications of ultrasonography in the shoulder and elbow[J].Journal of the American Academy of Orthopaedic Surgeons,2018,26(9):303-312.
[15]DAY M,MCCORMACK R A,NAYYAR S,et al.Physician training ultrasound and accuracy of diagnosis in rotator cuff tears[J].Bulletin of the Hospital for Joint Diseases,2016,74(3):207-211.
[16]VAN DYCK P,GIELEN J L,VERYSER J,et al.Tears of the supraspinatus tendon:assessment with indirect magnetic resonance arthrography in 67patients with arthroscopic correlation[J].Acta Radiologica,2009,50(9):1057-1063.
[17]SHARMA G,BHANDARY S,Khandige G,et al.MR imaging of rotator cuff tears:correlation with arthroscopy[J].Journal of Clinical and Diagnostic Research:JCDR,2017,11(5):24-27.
[18]DE JESUS J O,PARKER L,FRANGOS A J,et al.Accuracy of MRI,MR arthrography,and ultrasound in the diagnosis of rotator cuff tears:a meta-analysis[J].AJR:American Journal of Roentgenology,2009,192(6):1701-1707.
[19]FINNAN R P,CROSBY L A.Partial-thickness rotator cuff tears[J].Journal of Shoulder&Elbow Surgery,2010,19(4):609-616.
[20]FUKUDA H,MIKASA M,YAMANAKA K.Incomplete thickness rotator cuff tears diagnosed by subacromial bursography[J].Clinical Orthopaedics&Related Research,1987(223):51-58.
[21]SNYDER S J,PACHELLI A F,PIZZO W D,et al.Partial thickness rotator cuff tears:results of arthroscopic treatment[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,1991,7(1):1-7.
[22]LO I,GONZALEZ D M,BURKHART S S.The bubble sign:an arthroscopic indicator of an intratendinous rotator cuff tear[J].Arthroscopy:the Journal of Arthroscopic&Related Surgery,2002,18(9):1029-1033.
[23]ELLMAN H.Diagnosis and treatment of incomplete rotator cuff tears[J].Clinical Orthopaedics and Related Research,1990,254(254):64-74.
[24]YAMAMOTO N,MINETA M,KAWAKAMI J,et al.Risk factors for tear progression in symptomatic rotator cuff tears a prospective study of 174shoulders[J].American Journal of Sports Medicine,2017,45(11):2524-2531.
[25]SHIN K M.Partial-thickness rotator cuff tears[J].Korean Journal of Pain,2011,24(2):69-73.
[26]RUDZKI J R,SHAFFER B.New approaches to diagnosis and arthroscopic management of partial-thickness cuff tears[J].Clinics in Sports Medicine,2008,27(4):691-717.
[27]KONG B Y,CHO M,LEE H R,et al.Structural evolution of nonoperatively treated high-grade partial-thickness tears of the supraspinatus tendon[J].American Journal of Sports Medicine,2018,46(1):79-86.
[28]LO I K,DENKERS M R,MORE K D,et al.Partial-thickness rotator cuff tears:clinical and imaging outcomes and prognostic factors of successful nonoperative treatment[J].Open Access Journal of Sports Medicine,2018,9(18):191-197.
[29]KIM Y S,LEE H J,KIM J H,et al.When should we repair partial-thickness rotator cuff tears?Outcome comparison between immediate surgical repair versus delayed repair after 6-month period of nonsurgical treatment[J].American Journal of Sports Medicine,2018,46(5):1091-1096.
[30]YANG S,PARK H S,FLORES S,et al.Biomechanical analysis of bursal-sided partial thickness rotator cuff tears[J].Journal of Shoulder and Elbow Surgery,2009,18(3):379-385.
[31]PARK J Y,YOO M J,KIM M H.Comparison of surgical outcome between bursal and articular partial thickness rotator cuff tears[J].Orthopedics,2003,26(4):387-390.
[32]CORDASCO F A,BACKER M,CRAIG E V,et al.The partial-thickness rotator cuff tear:is acromioplasty without repair sufficient[J]?American Journal of Sports Medicine,2002,30(2):257-260.
[33]XIAO Jian,CUI Guoqing.Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears[J].Journal of Shoulder and Elbow Surgery,2015,24(2):E41-E46.
[34]FUKUDA H,HAMADA K,NAKAJIMA T,et al.Partialthickness tears of the rotator cuff[J].Journal of Bone&Joint Surgery British Volume,2003,85(1):3-11.
[35]OZAKI J,FUJIMOTO S,NAKAGAWA Y,et al.Tears of the rotar cuff of the shoulder associated with pathological changes in the acromion:a study in cadavera[J].Journal of Bone and Joint Surgery-American Volume,1988,70(8):1224-1230.
[36]KIM S J,KIM S H,LIM S H,et al.Use of magnetic resonance arthrography to compare clinical features and structural integrity after arthroscopic repair of bursal versus articular side partial-thickness rotator cuff tears[J].American Journal of Sports Medicine,2013,41(9):2041-2047.
[37]PETERS K S,LAM P H,MURRELL G A.Repair of partialthickness rotator cuff tears:a biomechanical analysis of footprint contact pressure and strength in an ovine model[J].Arthroscopy-the Journal of Arthroscopic and Related Surgery,2010,26(7):877-884.
[38]CASTRICINI R,PANFOLI N,NITTOLI R,et al.Transtendon arthroscopic repair of partial-thickness,articular surface tears of the supraspinatus:results at 2years[J].Musculoskeletal Surgery,2009,93(1):49-54.
[39]OSTI L,BUDA M,ANDREOTTI M,et al.Transtendon repair in partial articular supraspinatus tendon tear[J].British Medical Bulletin,2017,123(1):19-34.
[40]AYDIN N,KARAISMAILOGLU B.High-grade bursal-side partial rotator cuff tears:comparison of mid-and long-term results following arthroscopic repair after conversion to a fullthickness tear[J].Journal of Orthopaedic Surgery and Research,2017,12(1):118.
[41]IYENGAR J J,PORAT S,BURNETT K R,et al.Magnetic resonance imaging tendon integrity assessment after arthroscopic partial-thickness rotator cuff repair[J].Arthroscopythe Journal of Arthroscopic and Related Surgery,2011,27(3):306-313.
[42]GERELI A,KOCAOGLU B,ULKU T K,et al.Completion repair exhibits increased healing characteristics compared with in situ repair of partial thickness bursal rotator cuff tears[J].Knee Surgery Sports Traumatology Arthroscopy,2018,26(8):2498-2504.
[43]SHIN S J.A comparison of 2repair techniques for partialthickness articular-sided rotator cuff tears[J].Arthroscopythe Journal of Arthroscopic and Related Surgery,2012,28(1):25-33.
[44]CHARLES M D,CHRISTIAN D R,COLE B J.The role of biologic therapy in rotator cuff tears and repairs[J].Current Reviews in Musculoskeletal Medicine,2018,11(1):150-161.
[45]YANG W Y,HAN Y H,CAO X W,et al.Platelet-rich plasma as a treatment for plantar fasciitis:a meta-analysis of randomized controlled trials[J].Medicine,2017,96(44):e8475.
[46]MILLER L E,PARRISH W R,ROIDES B,et al.Efficacy of platelet-rich plasma injections for symptomatic tendinopathy:systematic review and meta-analysis of randomised injectioncontrolled trials[J].BMJ Open Sport Exerc Med,2017,3(1):e237.
[47]SHAMS A,EL-SAYED M,GAMAL O,et al.Subacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears[J].European Journal of Orthopaedic Surgery&Traumatology,2016,26(8):1-6.
[48]D’AMBROSI R,PALUMBO F,PARONZINI A,et al.Platelet-rich plasma supplementation in arthroscopic repair of full-thickness rotator cuff tears:a randomized clinical trial[J].Musculoskeletal Surgery,2016,100(1):25-32.
[49]HOLTBY R,CHRISTAKIS M,MAMAN E,et al.Impact of platelet-rich plasma on arthroscopic repair of small-to MediumSized rotator cuff tears:a randomized controlled trial[J].Orthopaedic Journal of Sports Medicine,2016,4(9):1807713019.
[50]PATRICK V,PATRICK S,MATTHEW P,et al.Plateletrich plasma reduces retear rates after arthroscopic repair of small-and medium-sized rotator cuff tears but is not cost-effective[J].American Journal of Sports Medicine,2015,43(12):3071-3076.