肩关节镜手术治疗28例老年肩袖损伤的临床疗效观察

Clinical observation of 28 elderly patients with rotator cuff injury treated by shoulder arthroscopic surgery

[背景]观察肩关节镜手术治疗老年肩袖损伤的临床疗效.[病例报告]选择2014年5月—2016年6月间行关节镜手术治疗的28例老年肩袖损伤患者,术后定期门诊随访,指导患者进行功能锻炼,比较患者术前与术后末次随访时的美国加州大学洛杉矶分校(UCLA)肩关节评分,评价术后肩关节功能恢复情况.所有患者均随访24～36个月,平均28.6个月.术后无感染、切口不愈合、二次断裂等并发症发生.患者术前UCLA评分为14.6±3.5,术后末次随访时为33.5±3.2,相比较差异具有统计学意义(P<0. 05).28例患者中评分优16例,良10例,可2例,优良率为92.9%.术后末次随访时肩关节功能较术前明显改善.[讨论]肩关节镜手术治疗老年肩袖损伤可有效缓解疼痛,显著促进肩关节功能恢复.

BACKGROUND To observe the clinical efficacy of shoulder arthroscopic surgery on the rotator cuff injury in elderly patients. CASE REPORTS The 28 elderly patients with rotator cuff injuries who underwent shoulder arthroscopic surgery were selected between May 2014 and June 2016. Regular postoperative outpatient follow-up was conducted, and the patients were guided to do the functional exercises. The shoulder joint score of the University of California at Los Angeles(UCLA) were compared preoperatively and postoperatively at the last follow-up. The functional recovery of shoulder joint after operation was evaluated. All patients were followed up for 24-36 months, with an average of 28.6 months. No postoperative complications such as infection, wound nonunion and secondary fracture occurred. The average preoperative UCLA score was 14.6±3.5, the average postoperative UCLA score of the last follow-up was 33.5±3.2, the difference was statistically significant(P<0.05). Among the 28 patients, 16 had excellent score, 10 had good score, and 2 had fair score. The excellent and good rate was 92.9%. The shoulder joint function at the last postoperative follow-up significantly improved compared with that before surgery. DISCUSSION Shoulder arthroscopic surgery in the treatment of rotator cuff injuries in elderly patients could effectively alleviate pain and significantly promote the recovery of shoulder joint function.