tailieunhanh - Các yếu tố ảnh hưởng đến kết quả phẫu thuật

Tám mươi lăm phần trăm đến 95% bệnh nhân trải qua phẫu thuật sửa chữa chính rách rotator fullthickness có một giảm đáng kể đau vai và cải thiện chức năng vai. Các kết quả của phẫu thuật phụ thuộc vào các kỹ thuật phẫu thuật, mức độ của những thay đổi bệnh lý trong vòng bít rotator, | Full-Thickn ess Rotator Cuff Tears Factors Affecting Surgical Outcome Joseph P. lannotti MD PhD Abstract Eighty-five percent to 95 of patients who undergo primary surgical repair of fullthickness rotator cuff tears have a significant decrease in shoulder pain and improvement in shoulder function. The results of surgery are dependent on the surgical technique the extent of pathologic changes in the rotator cuff and the postoperative rehabilitation protocol. Preoperative factors associated with a less favorable result are the size of the tear the quality of the tissues the presence of a chronic rupture of the long head of the biceps tendon and the degree of preoperative shoulder weakness. Surgical factors associated with a less favorable result include inadequate acromioplasty residual symptomatic acromioclavicular arthritis inadequate rotator cuff tissue mobilization deltoid detachment or denervation and failure of rotator cuff healing. Clinical evaluation and preoperative imaging of the shoulder will improve patient selection and counseling. Meticulous surgical technique and postoperative rehabilitation will optimize the final result. J Am Acad Orthop Surg 1994 2 87-95 Disorders of the rotator cuff constitute the most common source of shoulder pain. The wide spectrum of pathologic conditions includes rotator cuff tendinitis partial- and full-thickness tears and calcific tendinopathy. Many etiologic factors underlie these conditions but the pathogenesis remains controversial. Important factors include age-related degeneration of the tendons mechanical impingement on the rotator cuff by subacromial and acromioclavicular joint spurs and changes in the vascularity of the rotator cuff tendon. However the natural history and progression of rotator cuff disease from simple tendinitis to partial- and full-thickness rotator cuff tears remain poorly understood and are an area of considerable debate. In this article I will review the preoperative evaluation of full-thickness