关节镜下双排锚钉缝线桥技术治疗伴骨质疏松老年肩袖损伤的临床疗效  

Clinical Outcomes of Arthroscopic Double-row Anchor Suture-bridge Technique Treating Elderly Osteoporotic Patients with Rotator Cuff Injury

作　　者：吴迎波[1] 乔为民[1] Wu Yingbo;Qiao Weimin(The Fourth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第四附属医院,乌鲁木齐830000

出　　处：《中国运动医学杂志》2021年第7期518-522,共5页Chinese Journal of Sports Medicine

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-202032)。

摘　　要：目的:探讨关节镜下双排锚钉缝线桥技术对伴有骨质疏松老年肩袖损伤的疗效。方法:2016年9月~2018年9月来我院就诊的65岁以上老年患者,年龄68.3岁(65~79岁),共29例,全部为伴骨质疏松的肩袖全层撕裂,均采用关节镜下双排锚钉缝线桥技术固定。2例脱访,其余27例均获得全程随访,其中男性3例,女性24例。分别于术后1月、3月、6月、1年进行随访。比较术前及末次随访时疼痛视觉模拟评分(VAS)、Constant-Murley评分、简明肩关节评分(SST)、关节活动度。术后1年复查肩关节MRI了解肩袖肌腱腱骨愈合及再撕裂情况。结果:27例患者随访1年。术前VAS评分5.9±1.7分,Constant-Murley评分57.3±10.6分,SST评分1.9±1.3分;关节活动度:前屈76.5±6.7°,外展83.1±13.7°,体侧外旋23.9±3.3°,外展90°外旋60.6±5.1°。术后1年VAS1.6±0.3分,Constant-Murley评分89.9±2.7分,SST评分8.9±0.7分;关节活动度:前屈161±10.3°,外展157.1±11.6°,体侧外旋43.5±2.8°,外展90°外旋80.1±3.9°。术后VAS评分较术前显著降低,Constant-Murley评分、SST评分及关节活动度较术前显著改善(均P<0.01),影像学检查结果未见肩袖再撕裂情况。结论:关节镜下双排锚钉缝线桥技术固定治疗伴有骨质疏松的老年全层撕裂的肩袖损伤临床效果肯定,患者术后疼痛明显减轻,肩关节活动度明显改善。Objective To explore the clinical efficacy of arthroscopic double-row anchor suture-bridge technique treating elderly osteoporotic patients with rotator cuff injury.Methods Twenty-nine el-derly osteoporotic patients with rotator cuff injury,at an average age of 68.3(ranging from 65 to 79)received arthroscopic double-row anchor suture-bridge between September 2016 and September 2018.Except two dropouts,the rest 27 patients,including 3 males and 24 females,finished the follow-up 1,3,6 and 12 months after the surgery. Before the operation and during the last follow-up,all pa-tients were measured the visual analogue scale(VAS) score, Constant-Murray scores(CMS), simpleshoulder test(SST) score and motion range of shoulder. One year after the surgery, magnetic reso-nance imaging(MRI) was used to assess the healing and re-tearing of the rotator cuff.Results Twentyseven patients completed one-year follow-up. The preoperative VAS,CMS and SST score were 5.9 ±1.7,57.3 ± 10.6 and 1.9 ± 1.3 respectively,and the average motion range of anteflexion,abduction,outward rotation and outward rotation of 90 degrees of abduction were 76.5 ± 6.7,83.1 ± 13.7,23.9 ± 3.3 and 60.6 ± 5.1. However,one year after the surgery,the average VAS decreased significantlyto 1.6 ± 0.3,while the average CMS,SST,as well as the motion range of flexion,abduction,out-ward rotation and outward rotation of 90 degrees of abduction improved significantly to 89.9 ± 2.7,8.9 ± 0.7,161 ± 10.3,157.1 ± 11.6,43.5 ± 2.8 and 80.1 ± 3.9 accordingly. Moreover,no re-tear-ing of the rotator cuff was found according to the MRI results.Conclusion The arthroscopic double-row anchor suture-bridge technique is of good clinical outcomes for elderly osteoporotic patients with ro-tator cuff injury,which significantly relieves the postoperative pain and improves the motion range ofshoulder.

关 键 词：肩袖 老年患者 骨质疏松 

分 类 号：R687.4[医药卫生—骨科学]