肩关节镜下肱二头肌腱长腱转位固定上关节囊重建修复巨大不可修复肩袖损伤的可行性  

The Feasibility of Arthroscopic Reconstruction of the Upper Joint Capsule with Transposition and Fixation of the Long Head of Biceps Tendon to Repair the Huge Irreparable Rotator Cuff Injury

作　　者：王小鹏 刘鹏 黄金亮 刘杨 杨勇 Wang Xiaopeng;Liu Peng;Huang Jinliang;Liu Yang;Yang Yong(Xinyu People's Hospital,Xinyu Jiangxi 330008,China)

机构地区：[1]新余市人民医院,江西新余330008

出　　处：《医疗装备》2024年第21期1-4,共4页Medical Equipment

基　　金：新余市科技计划支撑项目(余科发[2023]35号)。

摘　　要：目的分析肩关节镜下肱二头肌腱长腱(LHBT)转位固定上关节囊重建修复巨大不可修复肩袖损伤(RCI)的可行性。方法选取2021年1月至2023年12月医院收治的60例巨大不可修复RCI患者作为研究对象。所有患者均接受肩关节镜下LHBT转位固定上关节囊重建修复治疗,记录手术及随访结果,评价术后6个月患者的疼痛缓解优良率,比较术前及术后1、3、6个月患者的肩关节功能[采用加州大学肩关节评分系统(UCLA)评估]、肩关节活动度,并记录随访期间的并发症发生率。结果60例患者均顺利完成手术,平均手术时间为(96.25±8.74)min,平均随访时间为(6.25±0.81)个月,术后6个月的切口均为Ⅰ期愈合、疼痛缓解优良率为98.33%(59/60)。术后1、3、6个月患者的UCLA评分、肩关节活动度均高于术前,且随着随访时间延长患者的UCLA评分、肩关节活动度逐渐提高,差异有统计学意义(P<0.05)。随访期间,患者均未发生神经损伤症状、肩袖二次损伤、感染等并发症。结论肩关节镜下LHBT转位固定上关节囊重建修复巨大不可修复RCI具有较好的疼痛缓解效果,可提高患者的肩关节功能及活动度,且并发症风险低。Objective To analyze the feasibility of arthroscopic reconstruction of the upper joint capsule with transposition and fixation of the long head of biceps tendon(LHBT)to repair the huge irreparable rotator cuff injury(RCI).Methods With the selection of 60 patients with huge irreparable RCI admitted to the hospital from January 2021 to December 2023 as the research subjects,all patients received arthroscopic upper joint capsule reconstruction and repair treatment with LHBT transposition and fixation.In addition,surgical and follow-up results were recorded to evaluate the excellent rate of pain relief in patients 6 months after surgery.The shoulder joint function[evaluated by using the University of California Los Angeles(UCLA)]and range of motion of patients before surgery and at 1,3,and 6 months after surgery were compared,and the incidence of complications during follow-up was recorded.Results All 60 patients successfully completed the surgery,with an average operation time of(96.25±8.74)minutes and an average follow-up time of(6.25±0.81)months.Six months after operation,all the incisions of 60 patients were healed with stageⅠ,and the rate of pain relief was 98.33%(59/60).At 1,3 and 6 months after operation,the UCLA score and the range of motion for shoulder joint were higher than those before operation.With the extension of follow-up time,the UCLA score and the range of motion for shoulder joint of patients gradually increased,and the differences were statistically significant(P<0.05).During the follow-up period,the patients did not experience any symptoms of nerve damage,secondary rotator cuff injury,infection,or other complications.Conclusion With a good pain relief effect and a low risk of complications,arthroscopic reconstruction of the upper joint capsule with transposition and fixation of LHBT to repair the huge irreparable RCI can improve the shoulder joint function and range of motion of patients.

关 键 词：肩关节镜 肱二头肌腱长腱 上关节囊重建 肩袖损伤 

分 类 号：R687.4[医药卫生—骨科学]