关节镜下单双排固定治疗肩袖损伤的对比

Comparison of arthroscopic single-row and double-row rotator cuff injury repair

目的比较关节镜下单排固定（SR）和双排固定（DR）治疗肩袖损伤的疗效。方法23例肩袖损伤患者（23肩）按随机数字表法分为sR组（12例）和DR组（11例），SR组采用2枚锚钉、简单缝合固定，DR组采用3枚锚钉、内排褥式缝合固定。术后24个月评价其临床功能，包括疼痛视觉模拟量表（VAS）评分、Constant评分、美国肩肘外科协会（ASES）评分、美国加州大学肩关节评分系统（UCLA）评分、肩关节活动度（前屈、内旋、外旋）、手术时间及患者满意度，并比较两组再撕裂情况及其临床功能。结果SR组手术时间短于DR组[（115．8±25．0）min比（124．5±19．7）min，P=0．033]；两组临床功能（VAS、Constant、ASES、UCLA评分）、肩关节活动度（前屈、内旋、外旋）及患者满意度比较差异无统计学意义（P〉0．05）。SR组术后全层再撕裂2例，DR组2例，两组比较差异无统计学意义（P〉0．05）；SR组部分分层再撕裂和全层再撕裂7例，DR组2例，两组比较差异有统计学意义（P=0．041）；再撕裂患者临床功能（VAS、Constant、ASES、UCLA评分）比较差异无统计学意义（P〉0．05）。结论DR治疗2-5cm肩袖撕裂损伤在临床功能及再撕裂方面与SR相比并无明显优势。

Objective To compare the clinical effect of single-row （SR） and double-row （DR） rotator cuff injury repair. Methods Twenty-three patients with rotator cuff injury were randomized into SR group（ 12 patients） and DR group （ 11 patients） by ranom digits table. Two anchors and simple sutures were applied in SR group, three anchors and medial mattress sutures were applied in DR group. Clinical function were compared after operation 24 months, included pain visual analogue scale （VAS） scores, Constant scores, American Shoulder and Elbow Surgeons （ASES） scores, University of California at Los Angeles（UCLA） scores, range of shoulder motion （anteflexion, adtorsion conclination, external rotation）, operation time and patient＇s satisfaction were compared. Re-tear rate and clinical function were also analyzed. Results The operation time in SR group was shorter than that in DR group [ （ 115.8± 25.0） min vs. （124.5 ± 19.7） min,P = 0.033]. The scores of VAS, Constant, ASES, UCLA in two groups had no significant difference （P 〉 0.05 ）. The full-thickness re-tear in SR group was 2 patients, in DR group was 2 patients, there was no significant difference （P 〉 0.05 ）. The full-thickness re-tear and part-thickness re-tear in SR group was 7 patients, in DR group was 2 patients, there was significant difference（P = 0.041 ）. Furthermore, the scores of VAS, Constant, ASES, UCLA had no significant difference （P 〉 0.05）. Conclusion Compared with SR, 2 - 5 cm rotator cuff injury repaired by DR has no obviously advantage.