钙化性冈上肌腱炎的关节外微创清理和治疗  

Extra-articular arthroscopic treatment of rotator cuff calcifying tendonitis

作　　者：魏均强[1] 蔡谞[1] 刘玉杰[1] 王岩[1] 王志刚[1] 李众利[1] 樊宇平[1] 柴伟[1] 

机构地区：[1]解放军总医院骨外科,北京复兴路28号100853

出　　处：《中国矫形外科杂志》2008年第7期501-503,共3页Orthopedic Journal of China

摘　　要：[目的]探讨关节外关节镜下清理治疗保守治疗无效的慢性钙化性冈上肌腱炎的手术方法并评价其疗效。[方法]对18例(男5例,女13例;年龄34～78岁,平均56.4岁)患钙化性冈上肌腱炎伴肩部疼痛和活动受限,且保守疗法超过3个月无效的患者行关节镜下手术治疗。关节镜由肩峰下间隙进入,于肩关节外行肩峰下滑囊清理切除并探查和清除冈上肌腱钙化病灶。采用VAS疼痛评分、Constant-Murley评分和X线对患者进行手术前后的评估。[结果]平均随访时间为9个月(6～15个月),肩部疼痛和功能障碍消失或明显改善,平均VAS疼痛评分术前(7.8±0.6)分,术后(1.7±0.4)分。平均Constant-Murley评分术前为(61±7)分,术后最后一次复查为(91±4)分。术后X线显示仅2例患者钙化灶有少量残留,但术前症状消失。无需行肩袖修补者。[结论]关节镜下经关节外清除钙化沉积结合滑囊切除对保守治疗无效的慢性钙化性冈上肌腱炎是一种可靠和有效的治疗方法。[Objective] To evaluate the surgical technique and effectiveness of extra-articular arthroseopie debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment. [ Methods] Arthroseopie debridement was performed in 18 patients （ 5 males, 13 females; mean age 56.4, range 34 to 78 ） in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis. Arthroseopy was inserted into subaeromial interspace and burseetomy was done. Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroseopy. VAS pain score, Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery. [ Results] The mean follow-up period was 9 months （6 to 15 months）. Pain and functional disturbance of the shoulder disappeared or obviously improved. The average VAS pain score was （ 7.8 ± 0. 6 ） preoperatively and （ 1.7 ±0. 4 ） postoperatively. The average Constant-Murley score was （61 ± 7） preoperatively and （91 ±4） at the last follow-up. Radiograph showed little residual deposits in 2 eases but without preoperative symptoms. No ease need rotator cuff repair. [ Conclusion ] Extra-articular arthroseopie removal of calcium deposits together with burseetomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.

关 键 词：钙化性肌腱炎 肩袖 冈上肌腱炎 关节镜 羟基磷灰石结晶沉积症 

分 类 号：R687.2[医药卫生—骨科学]