Purpose: This study was designed to compare functional outcomes in patients undergoing revision repair of massive rotator cuff tears (retracted medial to the glenoid) with Goutallier Grade 4 atrophy and concomitant release of the suprascapular nerve to a similar group of patients with Grade 3 atrophy undergoing revision rotator cuff repair (RTCR) without nerve release. We hypothesized that patients undergoing nerve release would have more favorable functional outcomes as measured by the Modified University of California at Los Angeles shoulder rating scale (UCLA).
Patients and methods: Twenty-two patients underwent revision repair of massive rotator cuff tears with release of the suprascapular nerve at the suprascapular notch. We compared total preoperative, postoperative, and change in UCLA score in these patients to a similar group of 22 patients undergoing revision RTCR without suprascapular nerve release. Additionally, UCLA subscores between the two groups were compared preoperatively and at final follow-up.
Results: The average preoperative UCLA score in the nerve-release group was 7.91, and final follow-up average was 27.86; average 3.05 grades of strength were recovered. In the comparison group, average preoperative UCLA score was 11.77, and final follow-up average was 29.09; average 1.32 grades of strength were recovered. The average preoperative UCLA score was significantly worse in the nerve-release group (P=0.007). The average postoperative UCLA score was not significantly different (P=0.590) between the groups, indicating a better improvement in the nerve-release group with significantly greater improvement in active forward flexion, strength, and pain relief.
Conclusion: Patients who underwent concomitant release of the suprascapular nerve during revision RTCR had greater overall improvement as noted in pain relief, active forward flexion, and strength, than a comparable group without nerve release.

Keywords: muscle atrophy, suprascapular nerve release, revision rotator cuff repair, atrophy
 


中文翻译：

---

翻修关节镜修复大转子肩袖撕裂伴或不伴关节镜上肩cap上神经释放患者的功能结局比较

目的：本研究旨在比较患有Goutallier 4级萎缩和同时伴有肩3上神经释放的类似三级萎缩患者的功能性结局，该患者接受翻修大块肩袖撕裂（缩回盂盂）翻修肩袖修复术（RTCR），无神经释放。我们假设，经过改良的加州大学洛杉矶分校肩膀评定量表（UCLA）测算，接受神经释放的患者的功能结局将更为有利。
患者和方法：22例患者接受翻修修复大肩袖撕裂，并在肩release上切口处释放肩cap上神经。我们将这些患者的总术前，术后和UCLA评分的变化与22例接受翻修RTCR而无肩cap上神经释放的患者进行了比较。此外，在术前和最终随访时比较了两组之间的UCLA评分。
结果：神经释放组术前平均UCLA评分为7.91，最终随访平均为27.86。平均恢复了3.05级强度。对照组的术前UCLA平均得分为11.77，最终随访平均得分为29.09；平均恢复了1.32级强度。神经释放组术前平均UCLA评分明显较差（P = 0.007）。两组之间的术后平均UCLA评分无显着差异（P = 0.590），表明神经释放组有更好的改善，积极向前屈，力量和疼痛缓解的改善也更大。
结论：与没有神经释放的可比较组相比，在RTCR修订期间经历肩cap上神经同时释放的患者在疼痛缓解，主动前屈和力量方面有更大的总体改善。

关键词：肌肉萎缩，肩cap上神经释放，翻修肩袖修复，萎缩