摘要
目的探讨关节镜下锁骨远端切除术治疗症状性肩锁关节炎的临床疗效。方法回顾分析2020年1月—2021年3月采用关节镜下锁骨远端间接切除法治疗的14例症状性肩锁关节炎患者临床资料。男5例,女9例;年龄18~57岁,平均46.3岁。左肩4例,右肩10例。患者均无肩部外伤史,均合并肩峰撞击综合征。病程9~48个月,平均20.4个月。术前疼痛视觉模拟评分(VAS)为5~9分,平均7.6分。手术前后采用美国加州大学洛杉矶分校(UCLA)评分标准进行综合疗效评定,并计算患者满意率。结果14例患者均获随访,随访时间5~18个月,平均13个月。术后12例患者肩锁关节无疼痛;1例偶感轻度疼痛,药物可控制;1例术后2周即开始进行负重训练,导致肩锁关节半脱位,经保守治疗1个月后症状逐渐缓解。末次随访时UCLA评分为(30.2±3.4)分,较术前(22.1±6.2)分显著改善,差异有统计学意义(t=5.359,P<0.001);获优12例、良1例、可1例,患者满意率92.9%。结论关节镜下锁骨远端切除术治疗症状性肩锁关节炎是一种安全可靠、可重复的方法。
Objective To investigate the effectiveness of arthroscopic distal clavicle resection for the symptomatic acromioclavicular joint arthritis.Methods The clinical data of 14 patients with symptomatic acromioclavicular joint arthritis treated by arthroscopic indirect distal clavicle resection between January 2020 and March2021 were retrospectively analyzed.There were 5 males and 9 females with an average age of 46.3 years(range,18-57 years).The4 cases of left shoulder and 10 cases of right shoulder were accompanied with acromial impingement,without the history of shoulder trauma.The average disease duration was 20.4 months(range,9-48 months),and the average visual analogue scale(VAS) score was 7.6(range,5-9) preoperatively.The results were evaluated using the University of California Los Angeles(UCLA) shoulder rating score before and after operation,further,the patient satisfaction rate was also calculated.Results All 14 patients were followed up 5-18 months,with an average of 13 months.There was no postoperative pain of acromioclavicular joint in 12 patients;1 case had occasional mild pain,which could be controlled by painkillers.Moreover,there was only 1 acromioclavicular joint subluxation due to early fitness training at 2 weeks postoperatively,and the symptoms gradually relieved after 1 month of conservative treatments.The UCLA score was 22.1±6.2preoperatively,which improved to 30.2±3.4 at last follow-up,showing significant difference(t=5.359,P<0.001).The patient satisfaction rate was 92.9%,with 12 excellent cases,1 good case,and 1 fair case.Conclusion Arthroscopic distal clavicle resection for symptomatic acromioclavicular arthritis is a safe,reliable,and repeatable procedure.
作者
杨清均
卢文倩
尤田
张新涛
张文涛
李灿锋
YANG Qingjun;LU Wenqian;YOU Tian;ZHANG Xintao;ZHANG Wentao;LI Canfeng(Weifang Medical University,Weifang Shandong,261000,P.R.China;Shenzhen University,Shenzhen Guangdong,518000,P.R.China;Department of Sports Medicine,Peking University Shenzhen Hospital,Shenzhen Guangdong,518000,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2022年第6期698-702,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
广东省体育局科技创新和体育文化发展科研项目(GDSS2020N002)
北京大学深圳医院科研项目(LCYJ2020005)。
关键词
肩锁关节
关节镜手术
锁骨远端切除术
关节炎
Acromioclavicular joint
arthroscopic surgery
distal clavicle resection
arthritis
