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目的 探讨关节镜下阔筋膜补片桥接冈上肌治疗不可修复性巨大肩袖撕裂的临床疗效.方法 回顾性分析2015年7月至2017年7月采用关节镜下阔筋膜补片桥接冈上肌治疗的不可修复性巨大肩袖撕裂患者10例,男4例,女6例;年龄(61.3±2.9)岁(范围57～67岁);右肩7例,左肩3例;7例息肩为主力侧.术前症状持续时间(14.0±13.5)个月(范围1～48个月),2例有外伤史,所有病例均为初次手术.术后1周、6个月、1年、2年时行MR检查,评估阔筋膜补片桥接不可修复性巨大肩袖撕裂的转归愈合情况,并采用美国肩肘外科协会(American Shoulder& Elbow Surgeons,ASES)评分、美国加利福尼亚大学洛杉矶分校(University of California Los Angeles,UCLA)评分、Constant-Murley评分评估肩关节功能.结果 全部病例均可重建水平力偶,未出现围手术期并发症.术后2年ASES评分为(92.2±3.5)分(范围88.3～98.3分)、UCLA评分为(31.6±2.0)分(范围28～34分)、Constant-Murley评分为(85.2±5.4)分(范围78～93分),均较术前[分别为(32.7±16.2)分(范围15～75分)、(9.8±4.9)分(范围6～23分)、(32.4±15.7)分(范围14～72分)]提高,差异有统计学意义(t=1 1.254,P=0.000;t=12.111,P=0.000;t=8.948,P--0.000);疼痛视觉模拟评分为(0.6±0.5)分(范围0～1分),较术前的(6.4±1.3)分(范围3～8分)明显降低,差异有统计学意义(t=1 1.326,P=0.000).术后2年MRI显示9例患者阔筋膜补片同肩袖残端愈合良好,1例发生再撕裂并出现补片吸收现象.10例患者肩关节前屈、外展、内旋外旋活动度均明显改善,但存在不同程度的力弱(3～4级).结论 关节镜下阔筋膜补片桥接冈上肌治疗不可修复性巨大肩袖撕裂能有效改善肩关节功能,自体阔筋膜补片通过桥接可以与肩袖组织愈合.“,”Objective To investigate the clinical outcomes of arthroscopic bridging reconstruction of irreparable massive rotator cuff tears using autogenous fascia lata.Methods From July 2015 to July 2017,a total of 10 cases (4 male and 6 female) who were treated with arthroscopic bridging reconstruction for irreparable massive rotator cuff tears using autogenous fascia lata were retrospectively analyzed.The age before surgery was 61.3±2.9 years (range 57-67 years).There were 7 patients with right shoulders and 3 with left shoulders.The dominate sides were involved in 7 cases.The trauma history was documented in 2 shoulders.The duration of preoperative symptoms was 14.0±13.5 months (1-48 months).The case with revision surgery was not included.The patients were examined with magnetic resonance imaging (MRI) to evaluate the healing of fascia lata patch bridging in the joint at one week,six months,one year and two years after operation.The motion range of shoulder and the clinical scores,including visual analogue scale (VAS),University of California Los Angeles (UCLA) score,Constant-Murley score and American Shoulder & Elbow Surgeons (ASES) score,were measured before surgery and at follow-up duration.Results All cases were reconstrncted the horizontal couple.No perioperative complication was occurred and all surgery were completed safely and successfully.At the end of two years,the score of ASES was 92.2±3.5 (range 88.3-98.3),UCLA 31.6±2.0 (range 28-34),Constant-Murley 85.2± 5.4 (range 78-93) with significant difference (t=11.254,P=0.000;t=12.111,P=0.000;t=8.948,P=-0.00) comparing with that bofore surgery.The VAS pain score was 0.6±0.5 (range 0-1) which was significantly lower than that preoperatively (t=1 1.326,P=0.000).At 2 years after operation,MRI shows that fascia lata patches healed well in 9 patients.However,one case was with re-tear and patch absorption.The range of motion of shoulder was significantly improved in all patients but with different degrees of weakness (3-4).Conclusion Arthroscopic bridging reconstruction using autogenous fascia lata could effectively improve shoulder function in patients with irreparable massive rotator cuff tears.The autogenous fascia lata patch can heal with the help of rotator cuff tissue through bridging reconstruction.