关节镜下部分修复术治疗70岁以上糖尿病病人巨大肩袖损伤的2年随访结果  

Arthroscopic partial repair for massive rotator cuff tear in diabetic patients over 70 years old:our experience in two⁃year follow⁃up

作　　者：俞银贤[1] 齐鑫 沈嘉康[1] 易诚青[1] YU Yin-xian;QI Xin;SHEN Jia-kang;YI Cheng-qing(Department of Orthopaedic Surgery,Shanghai General Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院骨科,上海200080

出　　处：《骨科》2020年第6期491-495,共5页ORTHOPAEDICS

基　　金：上海市浦江人才计划资助项目(2019PJD045)。

摘　　要：目的评估关节镜下部分修复术治疗70岁以上糖尿病病人巨大肩袖损伤的临床治疗效果。方法回顾性分析2016年1月至2018年6月在我院接受关节镜下部分修复术治疗的40例70岁以上2型糖尿病合并巨大肩袖损伤病人的临床资料,其中男16例,女24例;年龄为(72.05±2.01)岁(70~78岁);均仅修复肩胛下肌腱上部和冈下肌腱,恢复肩关节前方和后方的肩袖线缆附着。收集术前及末次随访时的肩关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、活动度、美国加利福尼亚大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分、Constant⁃Murley肩关节功能评分以及不良事件发生情况。结果本组随访(2.53±0.75)年(2~4年)。末次随访时的VAS评分、Constant⁃Mur⁃ley评分、UCLA评分分别为(0.72+0.68)分、(72.98+10.17)分、(30.48+1.66)分,被动前举、主动前举、被动外展、主动外展活动度分别为158.70°±5.82°、139.90°±4.12°、147.60°±12.02°、131.90°±19.89°,较术前均有显著改善,差异均有统计学意义(P均<0.05)。根据UCLA评分,33例为优良,7例为可,总体满意率为82.5%。结论利用带线锚钉关节镜下部分修复老年糖尿病病人巨大肩袖损伤可以明显改善肩关节功能,获得良好的临床效果。Objective To evaluate the clinical effect of arthroscopic partial repair for massive rotator cuff tear in diabetic patients over 70 years old.Methods Total of 40 elderly patients over 70 years old with type 2 diabetes complicated with huge rotator cuff injury who received arthroscopic partial repair in our hospital from January 2016 to June 2018 were retrospectively analyzed,including 16 males and 24 females,with an age of(72.05±2.01)years(70⁃78 years).Only the upper part of subscapular tendon and infraspinatus tendons were repaired,and the rotator cuff cable attachment in front of and behind the shoulder joint was restored.The visual analogue scale(VAS)score,range of motion,University of California Los Angeles(UCLA)shoulder score,Constant⁃Murley shoulder function score and adverse events before and at the last follow⁃up were collected.Results The patients were followed up for(2.53±0.75)years(2⁃4 years).The VAS score,Constant⁃Murley score and UCLA score at the last follow⁃up were 0.72±0.68,72.98±10.17 and 30.48±1.66,the range of motion of passive,active,passive abduction and active abduction was 158.70°±5.82°,139.90°±4.12°,147.60°±12.02°and 131.90°±19.89°,respectively,which were significantly improved as compared with those before operation(all P<0.05).According to UCLA score,33 cases were excellent and 7 cases were fair,and the overall satisfaction rate was 82.5%.Conclusion Arthroscopic partial repair of massive rotator cuff injury in elderly diabetic patients with a threaded anchor can significantly improve shoulder joint function and obtain good clinical results.

关 键 词：肩袖损伤 肩关节 关节镜 糖尿病 

分 类 号：R687.4[医药卫生—骨科学] R587.1[医药卫生—外科学]