关节镜下全缝线锚钉固定治疗肩袖损伤的临床研究  

A clinical study of arthroscopic all -suture anchor fixation for treatment of rotator cuff injuries

作　　者：王鹏 危立军 WANG Peng;WEI Lijun(Putuo Puzhou Hospital,Zhoushan 316199,Zhejiang,China)

机构地区：[1]普陀普舟医院,浙江舟山316199

出　　处：《中医正骨》2023年第10期26-30,36,共6页The Journal of Traditional Chinese Orthopedics and Traumatology

摘　　要：目的:观察关节镜下全缝线锚钉固定治疗肩袖损伤的临床疗效及安全性。方法:回顾性分析96例肩袖损伤患者的病例资料,均在关节镜下手术,其中采用全缝线锚钉固定治疗50例(全缝线锚钉组)、采用传统锚钉固定治疗46例(传统锚钉组)。比较2组患者的肩部疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国加州大学(the University of California at Los Angeles,UCLA)肩关节评分、美国肩肘外科协会(American shoulder and elbow surgeons,ASES)评分、Constant-Murley肩关节评分、肩关节活动度(外旋、外展、上举)及并发症发生率。结果:术前2组患者的肩部疼痛VAS评分比较,组间差异无统计学意义;术后1年,2组患者的肩部疼痛VAS评分均降低(t=32.920,P=0.000;t=13.325,P=0.000),且全缝线锚钉组的肩部疼痛VAS评分低于传统锚钉组[(1.58±0.61)分,(3.35±0.48)分,t=15.683,P=0.000]。术前2组患者的UCLA肩关节评分、ASES评分、Constant-Murley肩关节评分比较,组间差异均无统计学意义;术后1年,2组患者的UCLA肩关节评分、ASES评分、Constant-Murley肩关节评分均增加,但2组间的差异均无统计学意义。术前2组患者的肩关节外旋、外展、上举活动度比较,组间差异均无统计学意义;术后1年,2组患者的肩关节外旋、外展、上举活动度均增加,但2组间的差异均无统计学意义。术后至末次随访时(术后1年),全缝线锚钉组出现肩关节僵硬1例、锚钉脱出1例、骨髓水肿2例,传统锚钉组出现肩关节僵硬9例、肩袖再次撕裂6例、锚钉脱出10例、骨髓水肿11例,全缝线锚钉组的并发症发生率低于传统锚钉组(χ^(2)=48.661,P=0.000)。结论:关节镜下全缝线锚钉固定与传统锚钉固定治疗肩袖损伤的临床疗效相当,但前者能更好地缓解肩部疼痛、减少并发症发生。Objective:To observe the elinical outcomes and safety of arthroscopie ll-suture anchor(ASA)fixation for treatment of rota-tor cuff injuries.Methods:The clinical data of 96 patients with rotator cuff injuries were analyzed retrospectively.Fifty patients were treated with the ASA fixation(ASA group),and 46 ones with conventional anchor(CA)fix ation(CA group).The procedures were alll conducted umder arthroscope.The shoulder pain visual analogue scale(VAS)score,the University of California at Los Angeles(UCLA)shoulder score,Americ an shoulder and elbow surgeons(ASES)score,Constant-Murley shoulder score,shoulder range of motions(ROMs)including outward rot ation,abduction,upward lift and postoperative complication incidence were compared between the 2 groups.Results:The diference was not staistitcally significant in the shoulder pain VAS score between the 2 groups before the procedure;however,at 12 months ater the procedure,the shoulder pain VAS score decreased in the 2 groups(t=32.920,P=0.000;t=13.325,P=0.000),and it was lower in ASA group compared to CA group(1.58+0.61 vs 3.35+0.48 points,t=15.683,P=0.000).The dfferencese were not satistically significant in UCLA shoulder score,ASES score and Const ant-Murley shoulder score between the 2 groups before the procedure;however,at 12 months after the procedure,the UCLA shoulder score,ASES score and Constant-Murley shoulder score increased in the 2 groups,while the differences were not stistically significant between the 2 groups.The diferences were not stitically significant in shoulder ROMs,including outward rotation,abduction and upward lift,between the 2 groups before the procedure;however,at 12 months after the procedure,the shoulder ROMs,ineluding outward rotation,abduction and upward lift,increased in the 2 groups,while the diferences were not stititally significant between the 2 groups.From the post-procedure to the last fllowup(at 12 months after the procedure),the shoulder sifness(1 case),anchor protrusion(1 case)and bone marrow edema(2 cases)were found in ASA gr

关 键 词：肩袖损伤 关节镜检查 缝合锚 临床试验 

分 类 号：R687.4[医药卫生—骨科学]