关节镜自体骨软骨移植治疗复发性肩关节前脱位早期疗效  

Early efficacy analysis on arthroscopic autologous osteochondral grafting in the treatment of recurrent anterior shoulder dislocation

作　　者：张明涛 刘嘉鑫 杨智涛 刘涛[1] 张柏荣 安丽萍[1,2] 韵向东 ZHANG Ming-tao;LIU Jia-xin;YANG Zhi-tao;LIU Tao;ZHANG Bo-rong;AN Li-ping;YUN Xiang-dong(不详;Department of Orthopaedics,the Second Hospital of Lanzhou University,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学第二医院骨科,甘肃兰州730030 [2]甘肃省骨关节疾病研究重点实验室,甘肃兰州730030

出　　处：《中国骨伤》2022年第3期233-237,共5页China Journal of Orthopaedics and Traumatology

基　　金：甘肃省科技厅自然科学基金项目(编号:20JR10RA723);兰州大学第二医院“萃英科技创新”计划临床拔尖技术研究项目(编号:CY2019-BJ04)。

摘　　要：目的:探讨关节镜自体骨软骨移植治疗复发性肩关节前脱位的早期疗效。方法:选取2019年1月至2021年1月行关节镜自体骨软骨移植治疗复发性肩关节前脱位的患者17例,其中男12例,女5例,年龄17~55(32.88±12.33)岁。比较术前、术后6个月、末次随访时Rowe肩关节不稳评分(Rowes rating system for Bankart repair,Rowe),牛津大学肩关节不稳评分(Oxford Shoulder Instability Score,OSIS)及简便肩关节功能测试评分(Simple Shoulder Test,SST)评价肩关节功能,并记录术前、末次随访时肩关节活动度及术中、术后并发症。结果:17例患者术后均获得随访,时间7~25(18.4±5.4)个月。随访期间患者未出现血管、神经损伤及再脱位发生情况。Rowe评分由术前的(26.2±6.0)分增至术后6个月、末次随访的(74.4±4.0)、(82.4±3.1)分,术后不同时间点与术前比较,差异有统计学意义(P<0.05);OSIS评分由术前的(37.0±3.6)分增至术后6个月、末次随访的(47.4±2.6)、(52.7±2.6)分,术后不同时间点与术前比较,差异有统计学意义(P<0.05);SST评分由术前的(6.8±0.7)分增至术后6个月、末次随访的(9.8±0.8)、(11.6±2.6)分,术后不同时间点与术前比较,差异有统计学意义(P<0.05)。末次随访时患者主动体侧外旋和外展外旋活动度较术前明显改善。结论:关节镜自体关软骨移植治疗关节盂骨折缺损<20%的复发性肩关节前脱位患者可取得令人满意的早期临床疗效及稳定性,是一种可靠且有效的手术。Objective:To investigate the early efficacy of arthroscopic autologous osteochondral grafting in the treatment of recurrent anterior shoulder dislocation.Methods:From January 2019 to January 2021,17 patients with recurrent anterior dislocation of shoulder who underwent arthroscopic autologous osteochondral grafting were selected,including 12 males and 5 females,ranging in age from 17 to 55 years old,with a mean of(32.88±12.33)years old.Rowes rating system for Bankart repair(Rowe),Oxford Shoulder Instability Score(OSIS)and Simple Shoulder Test(SST)were compared before operation,6 months after operation and at the latest follow-up.OSIS and SST used to evaluate shoulder function were recorded before surgery and at the latest follow-up.The shoulder mobility and intraoperative and postoperative complications were also recorded.Results:All 17 patients were followed up,and the duration ranged from 7 to 25 months,with a mean of(18.4±5.4)months.During the follow-up period,there was no re-dislocation,no vascular or nerve injury.Rowe score increased from 26.2±6.0 before operation to 74.4±4.0 and 82.4±3.1 after 6 months and the latest follow-up.There was significant difference in Rowe score between different time points after operation and before operation(P<0.05).The OSIS increased from 37.0±3.6 before operation to 47.4±2.6 and 52.7±2.6 after 6 months and the latest follow-up.There was significant difference in OSIS between different time points after operation and before operation(P<0.05).The SST score increased from 6.8±0.7 before operation to 9.8±0.8,11.6±2.6 after 6 months and the latest follow-up.There was significant difference in SST score between different time points after operation and before operation(P<0.05).At the latest follow-up,the lateral external rotation and abduction external rotation activities of the patient were significantly improved compared with those before operation.Conclusion:This study provides preliminary evidence that arthroscopic autologous osteochondral grafting can achieve satis

关 键 词：肩脱位 移植 自体 骨移植 关节镜 

分 类 号：R684.7[医药卫生—骨科学]