关节镜下手术治疗老年退行性肩袖撕裂的疗效分析  

A study of arthroscopic rotator cuff repair in elder patients

作　　者：程飚[1] 李伯休[1] 陈意磊[1] 陈峥嵘[1] 

机构地区：[1]复旦大学附属中山医院骨科,上海200032

出　　处：《中华手外科杂志》2007年第6期330-332,共3页Chinese Journal of Hand Surgery

摘　　要：目的探讨关节镜下手术治疗老年退行性肩袖撕裂的疗效。方法2002年9月—2005年6月,对16例50岁以上肩袖撕裂的患者,采用关节镜下手术治疗。根据肩袖撕裂的大小和形状分成新月形和"U"形,新月形撕裂直接采用Mitek(GⅡ)铆钉腱骨缝合的方法,"U"形撕裂采用对边缝合后加用Mitek(GⅡ)铆钉固定的方法。结果16例患者均获得随访,随访时间为12～24个月,平均15个月。术前、术后的功能情况采用UCLA肩关节评分系统进行疗效评价:优8例,良7例,可1例,优良率为93.5%。术后无明显的并发症,两种修补方法疗效相同。结论关节镜下手术创伤小、出血少、术后恢复快,且能最大程度地恢复肩关节的功能,是治疗老年人肩峰撞击肩袖撕裂的首选术式。Objective To evaluate the functional results of arthroscopic rotator cuff repair in patients over 50 years old. Methods Between September 2002 and June 2005, 16 patients over 50 years old with rotator cuff tear were treated with arthroscopy repair. Retrospective study was carried out of these cases. Tears were categorized according to the size and pattern of the tear （crescent shape and U-shape）. Crescent-shaped tears were repaired in a direct tendon-to-bone fashion using Mitek tendon anchor, while U-shaped tears were repaired by a margin-convergence technique enhanced by Mitek anchor. Of this group, all patients were available for follow-up. Preoperative and postoperative functions were assessed by means of a UCLA scoring system. Results Sixteen cases were followed-up for 15 months on average, ranging from 12 months to 24 months. The results were excellent in 8 cases, good in 7 cases, and fair in 1 case. The excellent and good rate was 93.5%. No major postoperative complications were noted. U-shaped tears repaired by margin convergence had results comparable to those of crescent-shaped tears repaired directly by a tendon-to-bone technique. Conclusion Arthroscopic rotator cuff repair is minimally invasive, causes less blood loss, and leads to faster return of full overhead function of the shoulder joint. It therefore is the first choice for management of rotator cuff tear with impingement in older patients.

关 键 词：关节镜 关节成形术 肩关节 肩袖撕裂 

分 类 号：R687.4[医药卫生—骨科学]