中老年原发性冻结肩及肩袖钙化症的肩关节镜治疗

Treatment of Primary Frozen Shoulder and Calcifying Rotator Cuff Tendonitis with Arthroscope in Middle-aged and Elderly People

目的探讨中老年原发性冻结肩及肩袖钙化症的肩关节镜手术技巧与疗效。方法对非手术治疗无效的15例原发性冻结肩行肩关节镜下关节囊松解,4例合并肩袖钙化症,均行钙化灶清除及肩峰成形术。术前、术后采用ASES、VAS评分法和Constant肩关节功能评分法评估。结果术后平均随访27.3个月。术后疼痛程度及功能评分均有显著提高,肩关节活动度亦有较明显改善(P<0.01)。结论中老年原发性冻结肩及肩袖钙化症的肩关节镜治疗是一种损伤小、恢复快,安全有效的方法。

Objective To explore the clinical effect and surgical skills of the arthroscopic treatment of primary frozen shoulder and the cal- cifying rotator cuff tendonitis in the middle- aged and the elderly people. Methods Fifteen patients with primary frozen shoulder were treated with arthroscopic capsular release. Four patients complicated with the calcifying rotator cuff tendonitis underwent arthroscopic calcium excision and acromioplasty. All patients were strictly evaluated by ASES （American shoulder ＆ elbow surgeon） score, Constant score, normalized Constant score and the Visual analog scale, before and after operation respectively. Results All patients got average follow- up of 27.3 months, and had significant improvement of functional recovery and pain relief after surgery. Conclusion Arthroscopic capsular release is a safe and effective surgical methods in the therapy of primary frozen shoulder and the calcifying rotator cuff tendonitis unresponsive to conservative treatment. It has advantages of minimal wound, quick recovery, lower adherence rate and less complications.