摘要
目的比较肩关节镜下双滑轮结合缝线桥技术与传统缝线桥技术固定修复肩袖损伤的临床疗效。方法选取80例诊断为中型、大型肩袖损伤的患者,按治疗方式分为观察组和对照组,每组40例。观察组采用关节镜下双滑轮结合缝线桥技术治疗,对照组采用传统缝线桥技术治疗。记录2组患者手术相关指标及并发症发生情况。比较2组术前及术后不同时间点视觉模拟量表(VAS)评分、Constant评分、美国加州大学肩关节评分系统(UCLA)评分、美国肩与肘协会评分系统(ASES)评分,比较2组患者术后6个月、12个月肩关节前屈、外旋活动度和术后12个月肩关节再撕裂发生率。结果2组患者手术时间、术中出血量及术后住院时间比较差异无统计学意义(P>0.05)。术中及术后均无血管神经损伤、锚钉拔出、深部感染等并发症发生。2组患者术后各时间点VAS评分均较术前明显降低(P<0.05),术后3个月、6个月、12个月Constant评分、UCLA评分、ASES评分均较术前明显提高(P<0.05);观察组术后3 d、3个月、6个月VAS评分明显低于对照组(P<0.05),术后3个月、6个月Constant评分、UCLA评分、ASES评分明显高于对照组(P<0.05)。2组患者术后6个月、12个月肩关节前屈、外旋活动度均较术前明显增加(P<0.05),且观察组患者术后6个月肩关节前屈、外旋活动度大于对照组(P<0.05)。观察组患者术后12个月未见修复肩袖再撕裂,对照组再撕裂发生率为10%,2组比较差异有统计学意义(P<0.05)。结论关节镜下双滑轮结合缝线桥技术与传统缝线桥技术修复中型、大型肩袖损伤都有较好的临床效果,能较好恢复肩关节功能,但双滑轮结合缝线桥技术更能减轻患者术后疼痛,促进肩关节功能尽快恢复,明显降低术后肩袖再撕裂的发生率,安全性更好,患者预后更佳。
Objective To compare the clinical efficacy of double pulley combined with suture bridge technique under shoulder arthroscopy and traditional suture bridge technique for repairing rotator cuff injury.Methods A total of 80 patients diagnosed as medium and large rotator cuff injuries were selected,and were divided into the observation group and the control group according to the treatment methods,with 40 patients in each group.Patients in the observation group were treated with double pulley combined with suture bridge technique under shoulder arthroscopy,and patients in the control group were treated with traditional suture bridge technique.The operation-related indicators and complications of the two groups were recorded.Visual analogue scale(VAS)score,Constant score,University of California,Los Angeles shoulder rating scale(UCLA)score and American Shoulder and Elbow Surgeons(ASES)score of the two groups before operation and at different time points after operation were compared,and the range of motion of the shoulder anterior flexion and external rotation 6 and 12 months after operation and the incidence of the shoulder re-tear between the two groups 12 months after operation were compared.Results There was no significant difference in the operation time,intraoperative blood loss or postoperative hospital stay between the two groups(P>0.05).No complications such as vascular or nerve injury,anchor pullout,or deep infection occurred during and after operation.VAS scores at different time points after operation in the two groups were significantly lower than those before operation(P<0.05);Constant score,UCLA score and ASES score 3,6,12 months after operation in the two groups were significantly higher than those before operation(P<0.05);VAS scores of the observation group 3 days,3 months and 6 months after operation were significantly lower than those of the control group(P<0.05);Constant score,UCLA score and ASES score of the observation group 3,6 months were significantly higher than those of the control group(P<0.05).The range of motion of the shoulder anterior flexion and external rotation 6 and 12 months after operation in the two groups were significantly greater than those before operation(P<0.05),while the range of motion of the shoulder anterior flexion and external rotation in the observation group 6 months after operation were greater than those in the control group(P<0.05).No rotator cuff re-tear occurred in the observation group 12 months after operation,and the incidence of rotator cuff re-tear in the control group was 10%,there was a statistically significant difference between the two groups(P<0.05).Conclusion Both double pulley combined with suture bridge technique under shoulder arthroscopy and traditional suture bridge technique have good clinical effect on repairing medium and large rotator cuff injury and can restore shoulder joint function well;while double pulley combined with suture bridge technique can significantly relieve patients’postoperative pain,promote the recovery of the shoulder joint function as soon as possible,and significantly reduce the incidence of postoperative rotator cuff re-tear,with better safety and better prognosis of patients.
作者
骆勇刚
陈俊
庄万强
唐毅
唐康来
陈雍华
LUO Yong-gang;CHEN Jun;ZHUANG Wan-Qiang;TANG Yi;TANG Kang-lai;CHEN Yong-Hua(Second Department of Orthopaedics,Jianyang People’s Hospital,Jianyang Sichuan 641400,China;Department of Orthopaedics,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《局解手术学杂志》
2021年第6期535-540,共6页
Journal of Regional Anatomy and Operative Surgery
关键词
关节镜
肩袖损伤
修复
肩关节镜技术
缝线桥技术
双滑轮
arthroscopy
rotator cuff injury
repair
shoulder arthroscopy technology
suture bridge technology
double pulley
