摘要
目的比较关节镜下肩峰减压联合肩袖修复术与开放手术治疗老年肩峰撞击综合征合并全层肩袖损伤的临床疗效。方法纳入自2019-09—2021-09诊治的118例老年肩峰撞击综合征合并全层肩袖损伤,关节镜组59例采用关节镜下肩峰减压联合肩袖修复术治疗,开放手术组59例采用肩峰成形与肩袖修复术治疗。比较两组术后疼痛VAS评分、肩关节活动度、肩关节功能ASES评分优良率与三角肌肌力。结果纳入研究的118例均获得至少1年随访,所有患者术后疼痛明显缓解,肩关节活动度明显改善,肩关节功能恢复满意。关节镜组术后3个月、术后6个月、术后1年疼痛VAS评分低于开放手术组,术后6个月、术后1年肩关节前屈、外展、外展90°内旋、外展90°外旋活动度大于开放手术组,术后1年肩关节功能ASES评分优良率高于开放手术组,术后1年三角肌肌力评定结果优于开放手术组,差异有统计学意义(P<0.05)。结论关节镜下肩峰减压联合肩袖修复是治疗老年肩峰撞击综合征合并全层肩袖损伤的可靠手术方法,可以同时解决肩峰撞击与肩袖损伤的问题,有效缓解疼痛,恢复患者肩关节功能和活动度,改善三角肌肌力。临床医师应掌握术中修复肩袖的缝合技术,避免切除过多肩峰。
Objective To compare the clinical efficacy of arthroscopic acromial decompression combined with rotator cuff repair and open surgery in the treatment of acromial impingement syndrome in elderly patients with full-layer rotator cuff tears.Methods A total of 118 elderly patients with acromial impingement syndrome combined with full-layer rotator cuff tears were included from September 2019 to September 2021.Fifty-nine cases in the arthroscopic group were treated with arthroscopic acromial decompression combined with rotator cuff repair,and another 59 cases in the open surgery group were treated with acromial plasty combined with rotator cuff repair.Postoperative pain VAS score,shoulder joint range of motion,excellent and good rate of shoulder joint functional ASES score and deltoid muscle strength were compared between the two groups.Results All the 118 patients were followed up for at least 1 year.All the patients’pain was relieved significantly,their shoulder motion improved significantly,and their shoulder function recovered satisfactorily.The pain VAS scores of the arthroscopic group at 3 months,6 months and 1 year after surgery were lower than those of the open surgery group,the shoulder joint anterior flexion,abduction,abduction 90°internal rotation and abduction 90°external rotation were higher than those of the open surgery group at 6 months and 1 year after surgery,and the excellent and good rate of shoulder joint functional ASES scores at 1 year after surgery was higher than that of the open surgery group.The results of deltoid muscle strength evaluation 1 year after operation in the arthroscopic group were better than those in open operation group,and the difference was statistically significant(P<0.05).Conclusion Arthroscopic acromial decompression combined with rotator cuff repair is a reliable surgical method for the treatment of acromial impingement syndrome in elderly patients with full-layer rotator cuff tears,which can solve the problem of acromial impingement and rotator cuff tears at the sam
作者
胡文帅
范文俊
赵进喜
HU Wenshuai;FAN Wenjun;ZHAO Jinxi(Department of Orthopedic Surgery,Macheng People’s Hospital,Huanggang,Hubei 438300,China)
出处
《中国骨与关节损伤杂志》
2023年第7期709-713,共5页
Chinese Journal of Bone and Joint Injury
关键词
肩峰撞击综合征
全层肩袖损伤
关节镜
肩峰减压
肩袖修复
Shoulder impingement syndrome
Total rotator cuff tears
Arthroscopy
Acromion decompression
Rotator cuff repair
