关节镜下保留肩袖残端修复肩袖撕裂的疗效分析  被引量:1

Efficacy of arthroscopic repair of rotator cuff tear with preservation of rotator cuff stump

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作  者:张翼飞 张辰阳 张晓玲 陈润 陈双涛 ZHANG Yifei;ZHANG Chenyang;ZHANG Xiaoling;CHEN Run;CHEN Shuangtao(Department of Joint Surgery,Xingtai General Hospital,North China Medical and Health Group,Xingtai,Hebei 054000,China)

机构地区:[1]华北医疗健康集团邢台总医院关节科,河北邢台054000

出  处:《中国骨与关节损伤杂志》2023年第5期475-479,共5页Chinese Journal of Bone and Joint Injury

摘  要:目的探讨关节镜下保留肩袖残端修复经肌腱不规则肩袖撕裂的手术方法与临床疗效。方法回顾性分析自2019-03—2021-03诊治的7例经肌腱不规则肩袖撕裂,MRI显示肱骨大结节附着大量残余的肌腱组织,撕裂位于冈上肌肌腱的体部,撕裂方式不规则,残余的肌腱组织大小不一,采用关节镜下保留肌腱残端的双排缝合桥技术修复肩袖撕裂。结果7例均获得随访,随访时间平均13.9(12~16)个月。术后所有患者无疼痛、关节肿胀及肩关节活动受限等不适主诉,术后复查肩关节MRI显示肩袖愈合良好,无肩袖再次撕裂发生。术后6周疼痛VAS评分为4~6分,平均5.7分;术后3个月疼痛VAS评分为1~3分,平均1.8分;术后6个月疼痛VAS评分为1~3分,平均1.1分;术后12个月疼痛VAS评分为0~1分,平均0.3分。术后6周肩关节功能UCLA评分为18~26分,平均23.3分;术后3个月肩关节功能UCLA评分为19~31分,平均25.0分;术后6个月肩关节功能UCLA评分为22~29分,平均26.7分;术后12个月肩关节功能UCLA评分为29~35分,平均32.1分。结论对于肱骨大结节处残余较多肌腱的经肌腱不规则肩袖撕裂,采用关节镜下保留肩袖残端双排缝合桥技术修复可以保留肌腱的本体感受器,有利于肩关节本体感觉恢复,残余组织也有利于增强血管重建和改善关节稳定性。Objective To investigate the surgical methods and clinical effects of arthroscopic repair of irregular transotenoidal rotator cuff tears with preservation of the stump of the rotator cuff.Methods Seven patients with irregular transotenous rotator cuff tears were treated from March 2019 to March 2021.MRI showed that a large number of residual tendon tissue was attached to the greater tuberosity of the humerus,and the tear was located in the body of the supraspinatus tendon.The rotator cuff tear was repaired with arthroscopic tendon stump preserving double-row suture-bridge technique.Results All 7 patients were followed up for an average of 13.9(12-16)months.All patients had no complaints of discomfort such as pain,joint swelling and re-striction of shoulder joint activity after surgery.Postoperative review of shoulder joint MRI showed that rotator cuff healing was good,and no rotator cuff retearing occurred.The pain VAS score at 6 weeks after surgery was 4-6,with an average of 5.7 points.The pain VAS score of 3 months afer surgery was 1-3,with an average of 1.8 points.Six months after surgery,the pain VAS score was 1-3,with an average of 1.1 points.Twelve months after surgery,the pain VAS score was 0-1,with an average of 0.3.Six weeks after surgery,the UCLA score of shoulder joint function was 18-26 points,with an average of 23.3 points.Three months after surgery,the UCLA score of shoulder joint function was 19-31 points,with an average of 25.0 points.Six months after surgery,the UCLA score of shoulder joint function was 22-29 points,with an average of 26.7 points.The UCLA score of shoulder joint function 12 months after surgery ranged from 29 to 35 points with an average of 32.1 points.Conclusion For irregular rotator cuff tears with more residual tendons at the greater tuberculus of the humerus,the arthroscopic repair of rotator cuff residual double-row suture bridge technique can preserve the proprioception of the tendon,which is conducive to the recovery of proprioception of the shoulder joint,and the residual

关 键 词:经肌腱不规则肩袖撕裂 保留肌腱残端 关节镜 双排缝合桥技术 

分 类 号:R686.1[医药卫生—骨科学]

 

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