关节镜下保留残端修补对肩袖损伤术后肩关节功能及腱-骨界面愈合的影响OA

Objective:This study evaluates the effects of arthroscopic footprint-preserving surgical techniques in rotator cuff reconstruction.The primary focus centers on postoperative functional recovery and tendon-bone interface healing patterns at the tendon-bone interface.Methods:A total of 158 patients with rotator cuff tears treated between January 2023 to Janu-ary 2024 were enrolled.Seventy-nine patients underwent arthroscopic footprint-retaining rotator cuff repair(observation group),while 79 others underwent arthroscopic footprint-debridement rotator cuff repair(control group).Comparisons were made between the two groups regarding shoulder range of motion(forward flexion,abduction,external rotation at the side,and internal rotation in abduction),abduction strength ratio,American shoulder and elbow surgeons(ASES)score,Constant-Murley score,and pain visual ana-logue scale(VAS)score-assessed preoperatively and at 3 and 12 months postoperatively.Bone tunnel enlargement and T2 values at the graft tendon-bone interface were compared pre-operatively and at 12 months postoperatively.MRI was performed at 12 months to assess tendon healing using the Sugaya classification system.Postoperative complications were recorded during follow-up.Results:Repeated-measures ANOVA revealed statistically significant main effects of time and group,as well as a significant time and group interaction effect,on shoulder range of motion and the abduction strength ratio(all P<0.05).The observation group showed significantly greater shoulder range of motion and a higher abduction strength ratio than the control group at both 3 months and 12 months postoperatively(P<0.05).The analysis using the generalized estimating equation(GEE)model revealed that the Constant-Murley score,the ASES score,and the pain VAS score showed statistically significant differences among groups,over time,and in their interaction terms(P<0.05).At 12 months postoperatively,the degree of bone tunnel enlargement in the observation group was greater than that in the control group((2.26±0.24)mm vs(1.07±0.13)mm),and the T2 value at the graft tendon-bone junction was significantly lower in the observation group than that in the control group((54.08±10.23)ms vs(117.52±12.37)ms)(P<0.05).Sugaya classification system of tendon healing significantly favored the observation group(P<0.05).No complications occurred in either group.Conclusion:The arthroscopic residu-al tissue preservation and repair technique,by retaining the biologically active residual tissue,aligns with the combined traditional Chinese and Western medicine concept of"equal emphasis on tendons and bones",significantly improving the shoulder joint function of patients with rotator cuff injuries,reducing pain,optimizing the healing quality of the tendon-bone interface,and lowering the risk of re-tear.This surgical method's biological advantages align with the traditional Chinese medicine concept of"equal emphasis on tendons and bones"and"nourishing tendons with tendons",providing a modern anatomical and biomechanical foundation for exploring combined traditional Chinese and Western medicine reha-bilitation plans.