摘要
目的:比较评估关节镜下单排与缝线桥技术修复中型肩袖撕裂的临床疗效。方法:回顾性分析我科于2014年7月至2015年6月收治的55例中型肩袖撕裂患者,所有患者由同一医生于关节镜下以缝线锚钉单排(n=29)或缝线桥(n=26)技术修复撕裂肩袖。记录并比较术前及末次随访时的肩关节功能评分:美国肩肘外科医师协会评分(ASES评分)、美国加州大学洛杉矶分校肩关节评分(UCLA评分)和复旦大学肩关节评分(FUSS评分),以及疼痛视觉量表评分(VAS评分)和肩关节活动度(前屈、外展、体侧外旋)。末次随访时拍摄MRI以评估缝合肩袖的愈合情况。结果:50例患者获得随访,其中缝线桥组24例,单排组26例。两组间年龄、性别、随访时间、患侧差异无统计学意义。两组患者间术前功能评分(ASES,UCLA,FUSS)、VAS评分以及肩关节活动度(前屈,外展,体侧外旋)差异无统计学意义。术后两组患者各项指标均得到明显改善,但两组间差异无统计学意义。MRI检查发现两组均无患者出现再撕裂,缝线桥组sugayaⅠ型患者较单排组比例更高(83.3%vs 61.5%),但差异无统计学意义。结论:关节镜下缝线桥技术治疗中型肩袖撕裂早期结果优良,安全有效,但相比传统单排技术,未显示出明显优势,MRI结果虽提示肩袖愈合情况可能更优,远期疗效仍有待深入研究。
Objective To compare the outcomes of arthroscopic single-row and suture-bridge repairof medium-sized rotator cuff tears through clinical and MRI assessment. Methods Forty-five patientswith medium-sized rotator cuff tears who underwent arthroscopic repair using single-row（SR,n=29） orsuture-bridge（SB,n=26） technique between July 2014 to June 2015 in our hospital,were retrospective-ly enrolled in this study. All surgeries were performed by the same senior doctor. The functional out-comes were assessed using the rating scale of the University of California at Los Angeles（UCLA）,American Shoulder and Elbow Surgeons shoulder index（ASES）,Fudan University Shoulder Score（FUSS）,visual analog pain scale score（VAS）,and range of motion（ROM） before the operation andat the last follow-up. MRI examination was performed at the final follow-up. Results Finally 50 pa-tients were followed up successfully,24 in SB group and 26 in SR group. There were no significant dif-ferences between the two groups in terms of age,sex,follow-up duration,and the affected side. Beforethe operation,no significant differences were observed between the 2 groups in all the measurements.After more than 1- year follow- up,significant improvement was found in all measurements for bothgroups,but without significant differences between them. MRI examination showed no re-tears in either group. According to the Sugaya＇s classification,there were more type Ⅰ patients in SB group than SRgroup（83.3% vs 61.5%）,but the difference was not significant. Conclusion Arthroscopic suture-bridgerepairing of medium-sized rotator cuff tears results in safe and good early clinical outcomes. However,compared with the single-row technique,there was no significant advantage. Although the MRI examina-tion showed a better result of rotator cuff healing in the early stage,its long-term outcomes need fur-ther studying.
作者
刘少华
李宏
孙亚英
陈雨舟
陈世益
李云霞
陈疾忤
Liu Shaohua Li Hong Sun Yaying Chen Yuzhou Chen Shiyi Li Yunxia Chen Jiwu(Department of Sport Medieine, Huashan Hospital, Fudan University, Shanghai 200040, Chin)
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2017年第2期97-100,105,共5页
Chinese Journal of Sports Medicine
关键词
肩袖撕裂
缝线桥
单排
磁共振
rotator cuff tears
suture-bridge
single-row
MRI
