改良版康复程序在镜下Latarjet手术后的应用效果  

Effect of Modified Rehabilitation Program for Postoperative Management after Arthroscopic Latarjet Procedure

作　　者：孙维 雷红[2] 景玮祎 张振东[1] 黄炎[1] SUN Wei;LEI Hong;JING Wei-yi;ZHANG Zhen-dong;HUANG Yan(Department of Orthopedics and Sports Medicine,the 7th Center of PLAGH,Beijing 100700,China;Department of Rehabilitation,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]解放军总医院第七医学中心骨科,北京市100700 [2]北京大学第三医院康复医学科,北京市100191

出　　处：《中国康复理论与实践》2021年第2期191-196,共6页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨全关节镜下Latarjet手术后应用改良版康复程序治疗的临床效果。方法2017年7月至2019年3月,本中心共收治32例全关节镜下Latarjet手术治疗肩关节习惯性脱位的患者,随机分为对照组(n=15)和实验组(n=17)。对照组采用常规肩关节镜Bankart修复术后康复程序,实验组采用改良版关节镜下Latarjet术后康复程序。术后严格按照本科室制定的制动及康复方案进行治疗,分别于术前、术后3个月、术后6个月行疼痛视觉模拟评分(VAS)、患侧肩关节主动活动度(AROM)和肩关节功能评价。术后12个月评价患者满意度。结果32例患者均得到有效随访,所有患者均未出现再脱位。术后3个月时,实验组VAS、肩关节AROM和肩关节功能评分均优于对照组(|t|>2.149,P<0.05);术后6个月,两组VAS和肩关节AROM无显著性差异(|t|<1.481,P>0.05),实验组肩关节功能评分优于对照组(|t|>2.300,P<0.05);术后12个月终末随访时,实验组恢复投掷运动的比例和患者满意度(t=-4.564,P<0.001)高于对照组。结论与常规肩关节镜Bankart修复术后康复程序相比,全关节镜下Latarjet手术后应用本科室改良版术后康复程序安全有效,患者功能恢复更快,满意度高,早期临床效果好。Objective To assess the clinical outcomes of our modified postoperative rehabilitation program after total arthroscopic Latarjet procedure.Methods From July,2017 to March,2019,32 patients suffered from habitual anterior shoulder dislocation were treated with arthroscopic Latarjet procedure in our medical center.They were randomly assigned to control group(n=15)and experimental group(n=17).The control group received conventional rehabilitation program after shoulder arthroscopic Bankart repair,while the experimental group received modified rehabilitation program after arthroscopic Latarjet procedure.After surgery,they followed our postoperative management and rehabilitation program,and finished every phase of follow-up.Before and three weeks and six weeks after surgery,they were accessed with Visual Analogue Score(VAS)for pain,active range of motion(AROM)and functional assessment.Twelve months after surgery,their satisfaction were compared.Results None of them was lost at one-year follow-up postoperatively.No recurrent dislocation occurred.Three months after surgery,the VAS,AROM and the scores of shoulder functional assessments were better in the experimental group than in the control group(|t|>2.149,P<0.05).Six months after surgery,no significant difference was found in VAS and AROM between two groups(|t|<1.481,P>0.05),and the scores of shoulder functional assessments were better in the experimental group than in the control group(|t|>2.300,P<0.05).Twelve months after surgery,the percentage of restored throwing ability and patients'satisfaction(t=-4.564,P<0.001)were higher in the experimental group than in the control group.Conclusion Compared with the conventional rehabilitation program after shoulder arthroscopic Bankart repair,modified postoperative rehabilitation program for arthroscopic Latarjet procedure is safer and more effective,which could bring better functional outcomes and higher patients'satisfaction.

关 键 词：肩关节习惯性脱位 关节镜 Latarjet手术 康复 

分 类 号：R684[医药卫生—骨科学]