肩关节镜下单排缝合技术治疗不同程度肩袖损伤的效果评估

Evaluation of the Arthroscopic Single-row Suture Technique for Different Rotator Cuff Injury Study

目的:评估肩关节镜下单排缝合技术治疗不同程度肩袖损伤的效果。方法:选取2012年02月-2014年05月40例行肩关节镜下肩袖修补术患者,根据Gerber分型,其中中、小型肩袖损伤20例为一组(以下简称A组),大的、巨大肩袖损伤20例为一组(以下简称B组)。其中A组男12例,女8例,年龄37-77岁(平均年龄51岁),右侧15例,左侧5例;B组男10例,女10例,年龄40-78岁(平均年龄57岁),右侧18例,左侧2例。两组手术均采用金属缝合锚单排缝合技术进行肩袖修补,并采用ASES、Constant-Murley以及UCLA肩关节功能评分标准进行术前术后功能评估。结果:两组患者术后均获得随访,随访时间6-31个月(平均17.3个月)。通过术后肩关节活动度、三种肩关节功能评分与术前相比,差异有统计学意义(P<0.05)。A组各项评分优良率占为95%,B组优良率占85%。术后患者两组肩关节肿痛症状均明显好转,运动及生活功能恢复正常,肩关节活动度明显改善。A组较B组相比,有比较好的手术预期效果,且各项评分结果差异有统计学意义(P<0.05)。结论:缝合锚固件具有良好的相容性和适应性,固定可靠,具有高强度的优点,以获得稳定的早期固定。对于不同程度肩袖损伤,肩关节镜下单排缝合技术具有创伤小、恢复快、效果好等优势,配合重建后功能锻炼,肩关节功能能够恢复到令人满意的水平,但中小型肩袖撕裂的术后效果比较大的、巨大的肩袖撕裂好。

Objective： To evaluate the efficacies of the arthroscopic single-row suture technique for different rotator cuff injury.Methods： Between 2012 and 2015, a total of 40 cases were diagnosed with different types of rotator cuff injury study, of which 20 cases,the small rotator cuff injury for one group（Hereinafter referred to as Group A） according to Gerber classification.While the big or huge rotator cuff injury were divided into another group of 20 cases（Hereinafter referred to as Group B）. Group A included 12 males and 8females, aged 37-77 years old（The average age of 51 years old）. And they contained 15 cases of the right shoulder and 5 cases of the other. However, Group B included 10 males and 10 females, aged 40-78 years old（The average age of 57 years old）.They contained 18 cases of the right shoulder and 2 cases of the other. The technique of single-row metal suture anchor was applied to repair the rotator cuff in both groups of operation. In addition, the preoperative and postoperative shoulder function was measured according to ASES,Constant-Murley and UCLA shoulder function scores. Results： A mean time of 17.3 months（6-31 months） follow-up was completed after surgery. The range of motion and three shoulder function scores after surgery had significant differences when compared with those before operation（P0.05）. The excellent rate accounted for 95%, while the excellent rate in group B was 85%. Postoperative patients＇ shoulder swelling and pain had significant improvement, the range of shoulder motion had been obviously improved and sports and life function had dramatically been improved. Group A has better surgical expected results than group B. Conclusions： Suture anchor has the advantages of good compatibility and adaptation, reliable fixation with high strength in order to obtain stable early fixation, so that the arthroscopic single-row suture technique has the advantages of less trauma, quicker recovery and better results for the small rotator cuff injury. In combination with postoperative rehabilitative exercises, the function of shoulder can reach a satisfactory level.