摘要
目的比较关节镜下松解联合改良加强减张无结缝线桥技术或传统无结缝线桥技术治疗肩袖撕裂合并冻结肩的疗效。方法回顾性分析2017年6月至2020年6月,徐州医科大学附属医院关节外科采用关节镜下松解联合改良加强减张无结缝线桥技术(改良组30例)和传统无结缝线桥技术(传统组33例)治疗肩袖撕裂合并冻结肩的患者63例。采用t检验比较两组患者术前和末次随访时的疼痛视觉模拟评分(VAS),美国加州大学肩关节评分(UCLA)、美国肩肘外科医师学会评分(ASES)和肩关节活动度。根据肩关节MRI影像学Sugaya分型标准评估肩袖愈合情况,比较两组术后肩袖再撕裂发生率。结果患者术后随访(21±8)个月。两组患者在一般资料方面差异均无统计学意义(均为P>0.05)。两组患者术前肩关节活动度差异无统计学意义(均为P>0.05)。末次随访时,改良组的前屈、外展、体侧外旋优于传统组(t=3.750、3.244、2.554、均为P<0.05)。两组患者术前VAS、UCLA和ASES评分差异均无统计学意义(均为P>0.05)。末次随访时,改良组VAS、UCLA、ASES评分均优于传统组(t=2.405、3.884、3.899,均为P<0.05);改良组再撕裂为0,传统组再撕裂率为21.2%(χ^(2)=5.172,P=0.023)。结论对于肩袖撕裂合并冻结肩的患者,关节镜下松解联合改良加强减张无结缝线桥技术较传统无结缝线桥技术能获得更好的肩关节活动度和功能,疼痛减轻更明显,肩袖再撕裂发生率更低。
Objective To compare the efficacy of arthroscopic release combined with modified load sharing rip-stop and knotless suture bridge technique and traditional knotless suture bridge technique for rotator cuff tear repair in frozen shoulder.Methods A retrospective analysis was conducted on 63 patients with rotator cuff tear and frozen shoulder treated by arthroscopic release combined with modified load sharing rip-stop and knotless suture bridge technique(modified group,30 cases)or traditional knotless suture bridge technique(traditional group,33 cases)in the Joint Surgery Department of Xuzhou Medical University Affiliated Hospital from June 2017 to June 2020.Visual analogue scale(VAS),the University of California shoulder joint score(UCLA),the American Society of Shoulder and Elbow Surgeons(ASES)score,and range of motion of shoulder joint in the two groups were compared using t tests before surgery and at the last follow-up.The healing of the rotator cuff was evaluated by the Sugaya classification for shoulder joint MRI imaging,and the re-tearing incidence of rotator cuff after surgery was also compared.Results The patients were followed up for(21±8)months.There was no statistically significant difference in general information between the two groups(all P>0.05).No statistically significant difference was found in the range of motion of shoulder joint between the two groups before operation(all P>0.05).At the last follow-up,the modified group had better flexion,abduction,and lateral rotation than the traditional group(t=3.750,3.244,2.554,all P<0.05).There was no statistically significant difference in preoperative VAS,UCLA,nor ASES scores between the two groups(all P>005).At the last follow-up,the VAS,UCLA,and ASES scores of the modified group were better than those of the traditional group(t=2.405,3.884,3.899,all P<0.05).No re-tearing occurred in modified group,while the re-tearing rate of traditional group was 21.2%(χ^(2)=5.172,P=0.023).Conclusion For patients of rotator cuff tear combined with frozen shoulder,arthroscopic release combined with modified load sharing rip-stop and knotless suture bridge technique can achieve better shoulder joint mobility and function compared to traditional knotless suture bridge technique,with more effective pain relief and lower incidence of re-tearing of rotator cuff.
作者
李程
朱梁
庞勇
张星晨
查国春
郭开今
Li Cheng;Zhu Liang;Pang Yong;Zhang Xingchen;Zha Guochun;Guo Kaiji(The Affiliated Hospital of Xuzhou Medical University,Department of Orthopedics,Xuzhou 221006,China)
出处
《中华关节外科杂志（电子版）》
CAS
CSCD
2023年第3期424-429,共6页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
关节镜
肩关节
滑囊炎
缝合技术
Arthroscope
Shoulder joint
Bursitis
Suture techniques
