关节镜下缝合桥双排固定技术治疗肩袖全层撕裂的初步疗效  

The early clinical results of arthroscopic rotator cuff repair using a suture-bridge technique for full-thickness rotator cuff tears

作　　者：刘玉雷[1] 闫辉[1] 肖健[1] 崔国庆[1] 敖英芳[1] 

机构地区：[1]北京大学第三医院运动医学研究所,100191

出　　处：《中华关节外科杂志（电子版）》2011年第6期21-24,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的评价关节镜下应用缝合桥双排固定治疗肩袖全层撕裂的初步临床效果。方法回顾性分析北京大学第三医院2010年3月至2011年2月间应用关节镜下缝合桥双排固定技术治疗的44例肩袖全层撕裂患者的术后效果(男22例,女22例,术时平均52.3岁)。关节镜下将撕裂按大小分组。分别测定患者术前术后休息和运动时的VAS评分,肩关节前屈、外展和体侧外旋角度,美国加州大学肩关节评分(UCLA)和美国肩肘外科医生评分(ASES)。结果术后随访时间平均9.7个月,随访率100%。本组病例小撕裂14例(31.8%),中撕裂21例(47.7%),大撕裂5例(11.4%)和巨大撕裂4例(9.1%)。休息时VAS评分从术前(6.4±3.4)分降到随访时(0.7±1.5)分,活动时VAS评分从术前的(7.9±2.1)分降到随访时(1.8±1.8)分。手术前后的关节活动度有统计学差异(前屈、外展和体侧外旋的Z值分别为4.789,4.450和4.454,P<0.01)。UCLA评分由术前的(15.3±4.9)分增加到随访时(30.7±4.0)分;ASES评分由术前的(30.5±17.8)分增加到随访时(84.2±12.6)分,改变均有统计学意义(Z值分别为5.759和5.760,P<0.01)。患者对手术的满意率是93%,无术中和术后并发症。结论关节镜下缝合桥双排固定是一种治疗肩袖全层撕裂安全有效的方法,其长期临床效果需进一步研究。Objective To evaluate the early clinical results after arthroscopic rotator cuff repair using a suture-bridge technique for patients with full-thickness rotator cuff tears. Methods A retrospective analysis of 44 patients （ 22 males ; 22 females ; mean age 52. 3 years ） with full-thickness rotator cuff tears, who were treated consecutively between 2010 and 2011 at our clinic, was carried out to evaluate the outcome of arthroscopic suture-bridge technique. The visual analog pain scale scores （VAS） , the range of motion （ROM） , the rating scale of the University of California at Los Angeles （UCLA） , and the shoulder index of the American Shoulder and Elbow Surgeons （ASES） were determined as the evaluation criteria. Results The mean follow-up period was 9. 7 months. The follow-up rate was 100%. The study included 14 （31.8%） small, 21 （47.7%） medium, five （ 11.4% ） large and four （9. 1% ） massive rotator cuff tears. At the last follow-up, the VAS score decreased significantly from preoperative （6.4 ±3.4） to （0. 7 ±1.5 ） at rest, and from preoperative （7.9 ±2. 1 ） to （ 1.8 ± 1.8） during motion. The ROM improved significantly. The atisfactory rate was 93%. The UCLA score improved significantly from （15. 3±4. 9） preoperatively to （30. 7± 4.0 ） at follow-up. The ASES shoulder index improved significantly from （ 30. 5 ± 17. 8 ） preoperatively to （84. 2 ± 12. 6） at follow-up. There were no complications. Conclusions The early results of this study indicate that the arthroscopic suture-bridge technique is an effective and reliable treatment for patients with full-thickness rotator cuff tears. The long-term outcomes remain to be determined.

关 键 词：肩关节 肩袖 撕裂 关节镜 缝合技术 

分 类 号：R687.4[医药卫生—骨科学]