双排线桥混合穿骨缝合与双排线桥带线锚钉治疗中等大小肩袖撕裂的前瞻性随机对照研究  

Double Row Suture Bridge Hybird Transosseous Suture Technique Versus Double Row Suture Bridge Anchored Method in Patients With Medium Sized Rotator Cuff Tears:a Prospective Randomized Controlled Trial

作　　者：马佳[1] 张磊[1] 魏戌[1] 刘晓华[1] 李妍 韩庆欣 范丁元 冯敏山[1] Ma Jia;Zhang Lei;Wei Xu(Forth Department of Joints Surgery, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China)

机构地区：[1]中国中医科学院望京医院关节四科,北京100102

出　　处：《中国微创外科杂志》2022年第1期1-6,共6页Chinese Journal of Minimally Invasive Surgery

基　　金：北京市科学技术委员会“首都临床特色应用研究”专项资助课题(Z181100001718168)。

摘　　要：目的比较双排线桥混合穿骨缝合与双排线桥带线锚钉治疗中等大小肩袖撕裂的临床疗效。方法选取2018年10月~2020年2月我科82例肩袖中等大小全层撕裂,随机分为2组:观察组(双排线桥混合穿骨缝合)与对照组(双排线桥带线锚钉),比较2组患者术前(T_(0))及术后2周(T_(1))、6周(T_(2))、3个月(T_(3))、6个月(T_(4))、1年(T_(5))Constant-Murley评分、疼痛视觉模拟评分(Visual Analogue Scale,VAS)、活动度评分,采用MRI Sugaya分类对肩袖愈合情况进行评估。结果均未出现感染、神经损伤、大血管损伤、肩关节脱位等严重并发症。对照组1例因术后超声提示肩袖再撕裂行反式肩关节置换手术,剔除本研究,最终81例获得1年临床随访。对照组住院费用(59763.3±2718.3)元显著高于(49090.4±4434.0)元(t=13.095,P=0.000)。2组间VAS评分6个时间点差异均无显著性(P>0.05)。2组间Constant-Murley评分、活动度评分差异无统计学意义(F=0.340,P=0.562;F=1.749,P=0.190),组间和时间交的互作用差异无统计学意义(F=0.357,P=0.876;F=0.710,P=0.618)。术后1年随访2组MRI Sugaya分类差异无显著性(Z=-0.115,P=0.908)。结论双排线桥混合穿骨缝合与双排线桥带线锚钉治疗中等大小肩袖撕裂的临床疗效差异无统计学意义,双排线桥混合穿骨缝合肩袖修复方式经济性更优,兼具经济性与临床有效性。Objective To compare outcomes of double row suture bridge hybird transosseous suture(DRSB Hybird TOS)versus double row suture bridge anchored transosseous-equivalent(DRSB Anchored TOE)in patients with medium sized rotator cuff tears.Methods According to the inclusion criteria,82 patients with medium sized full-thickness rotator cuff tears in our department from October 2018 to February 2020 were selected for a prospective randomized controlled study.They were randomly divided into two groups:observation group(DRSB Hybird TOS)and control group(DRSB Anchored TOE).The Constant-Murley score,Visual Analogue Scale(VAS)and motion score at preoperation(T_(0))and postoperative 2 weeks(T_(1)),6 weeks(T_(2)),3 months(T_(3)),6 months(T_(4))and 1 year(T_(5))were compared between the two groups.We evaluated the rotator cuff healing by the Sugaya classification in magnetic resonance imaging.Results No severe complications such as infection,nerve injury,vascular injury,shoulder dislocation occurred in all the operations.One case in the control group underwent reverse shoulder replacement due to the re-tear of rotator cuff found by postoperative ultrasound.This case was excluded.Finally,81 cases were followed up for 1 year.The hospitalization cost of the control group was(59763.3±2718.3)yuan,which was significantly higher than that of the observation group[(49090.4±4434.0)yuan,t=13.095,P=0.000].There were no significant differences in VAS at 6 timepoints.There were no significant differences in the Constant-Murley score(F=0.340,P=0.562)and motion score(F=1.749,P=0.190)between the two groups,and there were no significant differences in grouping and time interaction(F=0.357,P=0.876;F=0.710,P=0.618).There were no significant differences in one-year follow-up magnetic resonance imaging(Sugaya classification)between the two groups(Z=-0.115,P=0.908).Conclusions There were no significant differences in clinical outcomes between the DRSB Hybird TOS and DRSB Anchored TOE in patients with medium sized rotator cuff tears.The method of DRS

关 键 词：穿骨缝合 肩袖撕裂 双排线桥 

分 类 号：TM2[一般工业技术—材料科学与工程]