关节镜下H-Loop无结双排技术与缝线桥技术修复L型肩袖撕裂的疗效比较  

Comparison of the outcome of H-Loop knotless double row technique and suture bridge technique in repairing L-typed rotator cuff tear under arthroscopy

作　　者：杨一韬 孟晨阳 龙毅 李成 张晋铭 侯景义[1] 杨睿[1] Yang Yitao;Meng Chenyang;Long Yi;Li Cheng;Zhang Jinming;Hou Jingyi;Yang Rui(Department of Sports Medicine,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510030,China)

机构地区：[1]中山大学孙逸仙纪念医院运动医学科,广州1510030

出　　处：《中华骨科杂志》2024年第14期970-978,共9页Chinese Journal of Orthopaedics

基　　金：广州市科技厅市校联合资助项目(SL2022A03J01158)。

摘　　要：目的比较关节镜下H-Loop无结双排技术与缝线桥技术修复L型肩袖撕裂的临床疗效。方法回顾性分析2019年1至2021年12月于中山大学孙逸仙纪念医院接受关节镜下修复L型肩袖损伤的患者58例。采用关节镜下H-Loop无结双排技术16例,男8例、女8例,年龄(63.69±8.78)岁(范围50~74岁);采用关节镜下缝线桥技术42例,男24例、女18例,年龄(61.02±7.02)岁(范围50~73岁)。观察指标包括美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分、美国加州大学洛杉矶分校(University of California Los Angeles)肩关节功能评分、Constant-Murley评分、简单肩关节功能检查(simple shoulder test,SST)评分、肩关节活动度及肌力。结果两组患者均获得随访,H-Loop组患者随访时间为(12.81±0.98)个月,缝线桥组为(13.29±0.94)个月。两组患者的年龄、性别、优势手、术前症状时间、撕裂形状、撕裂大小和肱二头肌长头腱切断等因素的差异无统计学意义(P>0.05)。H-Loop组患者手术时间为(67.50±16.02)min,较缝线桥组的(76.67±13.19)min更短,差异有统计学意义(t=2.234,P=0.031);锚钉数量(2.00±0)个,较缝线桥组的(4.14±0.35)个更少,差异有统计学意义(t=16.573,P<0.001)。H-Loop组和缝线桥组ASES评术前分别为(57.44±15.91)分和(58.21±16.58)分,术后1年提高至(92.00±4.41)分和(87.71±6.19)分,手术前后的差异有统计学意义(F=53.439,P<0.001;F=72.511,P<0.001);UCLA评分术前分别为(20.63±3.79)分和(20.83±5.78)分,术后1年提高至(31.56±3.65)分和(30.36±4.71)分,手术前后的差异有统计学意义(F=57.788,P<0.001;F=50.043,P<0.001);Constant-Murley评分术前分别为(68.50±15.31)分和(66.21±16.51)分,术后1年提高至(87.5±8.70)分和(86.33±9.14)分,手术前后的差异有统计学意义(F=6.733,P<0.001;F=30.173,P<0.001);SST评分术前分别为(6.38±3.76)分和(6.55±3.31)分,术后1年提高至(9.06±2.59)分和(9.17±2.45)分,手术前后的差异有统计学意义(F=2.Objective To compare the clinical efficacy of the H-Loop knotless double-row technique and the suture bridge technique in repairing L-shaped rotator cuff tears under arthroscopy.Methods A retrospective analysis was performed on 58 patients with L-shaped rotator cuff injuries who underwent arthroscopic repair at Sun Yat-sen Memorial Hospital,Sun Yat-sen University,between January 2019 and December 2021.The H-Loop knotless double-row technique was used in 16 cases(8 males and 8 females,mean age 63.69±8.78 years),while the suture bridge technique was used in 42 cases(24 males and 18 females,mean age 61.02±7.02 years).The American Shoulder and Elbow Surgeons(ASES)score,University of California Los Angeles Shoulder Score(UCLA),Simple Shoulder Test(SST),shoulder range of motion,and muscle strength were evaluated and compared between the two groups one year after surgery.Results The follow-up period was 12.81±0.98 months for the H-Loop group and 13.29±0.94 months for the suture bridge group.No significant differences were found between the groups in terms of age,sex,dominant hand,preoperative symptom duration,tear shape,tear size,or long head tendon amputation(P>0.05).The operative time was significantly shorter in the H-Loop group 67.50±16.02 minutes compared to the suture bridge group 76.67±13.19 minutes(t=2.234,P=0.031).Additionally,the number of anchors used was significantly lower in the H-Loop group 2.00±0 compared to the suture bridge group 4.14±0.35(t=16.573,P<0.001).The ASES scores increased significantly in both groups:from 57.44±15.91 to 92.00±4.41 in the H-Loop group and from 58.21±16.58 to 87.71±6.19 in the suture bridge group(F=53.439,P<0.001;F=72.511,P<0.001).Similarly,the UCLA scores improved from 20.63±3.79 to 31.56±3.65 in the H-Loop group and from 20.83±5.78 to 30.36±4.71 in the suture bridge group(F=57.788,P<0.001;F=50.043,P<0.001).The Constant-Murley scores also showed significant improvement:from 68.50±15.31 to 87.5±8.70 in the H-Loop group and from 66.21±16.51 to 86.33±9.14 in

关 键 词：回旋套损伤 关节镜检查 最小侵入性外科手术 无结技术 

分 类 号：R687.4[医药卫生—骨科学]