摘要
目的:探讨关节镜下保留关节侧肩袖组织通过单排技术修复EllmanⅢ级肩袖滑囊侧部分撕裂的临床疗效。方法:回顾分析2014年1月至2016年10月我院收治的31例EllmanⅢ级肩袖滑囊侧撕裂,所有患者均行关节镜下单排缝合,其中17例保留关节侧肩袖组织进行修复(A组),14例将部分撕裂转为全层后进行修复(B组)。比较末次随访时两组病例的患肩VAS疼痛评分、主动活动度、Constant-Murley功能评分、MRI结果的差异。结果:31例患者中,25例患者获得随访,其中A组14人,平均随访16.29(12~25)个月,B组11人,平均随访15.37(12~27)个月。两组患者间术前基本信息差异无统计学意义。术后两组患者各方向主动活动度均有显著改善(P<0.05)。末次随访时,两组患者肩关节疼痛VAS评分、功能评分均有显著改善,其中A组和B组的VAS评分分别由术前的6.50±1.16分和6.63±1.80分下降至末次随访时的0.86±0.57分(P<0.05)和0.91±0.63分(P<0.05)。A组和B组的Constant-Murley评分分别由术前的55.21±6.40分和54.37±6.30分提高至末次随访时的86.58±4.85分(P<0.05)和85.73±5.36分(P<0.05)。末次随访时,两组患者间各指标差异均无统计学意义(P>0.05)。末次随访时两组MRI检查均无再撕裂发生。结论:对于EllmanⅢ级肩袖滑囊侧部分撕裂,保留关节侧肩袖组织或转为全层后单排缝合修复均可显著改善患肩各项指标,两种术式的疗效无明显差异。
Objective To investigate the clinical outcome of Ellman grade Ⅲ bursal-side partial-thick-ness rotator cuff tears（b-PT-RCT）treated by the arthroscopic single-row technique with articular ten-don fibers reservation. Methods A retrospective study was conducted on 31 patients with Ellman gradeIII（b-PT-RCT）who underwent arthroscopic rotator cuff repair（RCR）with the single-row technique inour hospital between January 2014 and October 2016. The intact articular side tissue of the rotatorcuff was reserved in 17 patients of group A, and was resected to convert to a full-thickness cuff tearin 14 patients of group B. The visual analog pain scale（VAS）score, Constant-Murley score and shoul-der active range of motion（ROM）, and magnetic resonance imaging（MRI）results were compared betweenthe two groups during the last follow-up. Results Among the 31 patients, 25 were followed, with 14 ingroup A followed for an average of 16.29（12-25）months and 11 of group B followed for an average of15.37（12-27）months. There were no significant differences between the two groups in all measurementsbefore the intervention and at the last follow-up. After the operation, significant improvement was ob-served in all planes of the active ROM for both groups（P〈0.05）. The VAS score of group A and B de-creased significantly from 6.50 ± 1.16 and 6.63 ± 1.80 before the operation to 0.86 ± 0.57 and 0.91± 0.63 at the last follow-up（P〈0.05 for both）. However, the average Constant-Murley score improvedsignificantly from 55.21 ± 6.40 to 86.85 ± 4.85 in Group A（P〈0.05）, while from 54.37 ± 6.30 to85.73 ± 5.36 in group B（P〈0.05）. During the last follow-up, no retear occurred in both groups accord-ing to the MRI examination. Conclusion The outcome of single-row repair for grade Ⅲ bursal-sidedpartial-thickness rotator cuff tears with either articular tendon preservation or converting of the lesionto a full-thickness tear is satisfying. No significant differences were found in their clinical outcom
作者
郭标
于海洋
许健
马炜
杨东强
崔红林
付鹏飞
Guo Biao;Yu Haiyang;Xu Jian;Ma Wei;Yang Dongqiang;Cui Honglin;Fu Pengfei(The Department of Orthopedics of Fuyang People＇s Hospital, Fuyang 236004, Chin)
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2018年第5期367-372,共6页
Chinese Journal of Sports Medicine
关键词
关节镜
肩袖滑囊侧部分撕裂
单排缝合
锚钉
arthroscopy
bursal-side
partial-thickness
rotator cuff tear
single-row repair
rivet
