全关节镜下单排锚钉重建中小型肩袖撕裂

Reconstruction of small and medium rotator cuff tear with single row anchor under all-arthroscopy

目的探讨全关节镜下单排锚钉治疗中小型肩袖撕裂的临床疗效。方法自2014年1月至2016年12月对13例肩部疼痛、活动受限的患者，术前通过症状、体征、影像学检查，排除肩部其他疾病后均诊断为肩袖撕裂，并于术中进一步确认肩袖撕裂的大小，采用全关节镜下单排锚钉进行重建修复，术后随访采用美国加州大学肩关节评分系统（UCLA）进行评分。结果术后伤口均Ⅰ期愈合，无关节感染，无神经损伤，影像学检查无锚钉滑脱及肩袖再次撕裂。随访时间6-36个月，平均23个月，术后疼痛症状均得到有效缓解，肩关节功能恢复良好。根据UCLA进行评分：优10例，良2例，差1例。患者满意度100％。结论关节镜下单排锚钉重建中小型肩袖撕裂，具有操作简单、创伤小、手术时间短、术后疼痛轻、功能恢复快、费用相对低廉等优点，是修复此类损伤的理想治疗方法。

Objective To investigate the clinical efficacy of single row anchor under all-arthroscopy in the treatment of small and medium rotator cuff tear. Methods From January 2014 to December 2016, 13 cases of shoulder pain and activity limitation were diagnosed as shoulder rotator cuff tear after excluding other shoulder diseases by preoperative symptoms, signs, imaging examination. The rotator cuff tear size was further confirmed during the operation. Under all-arthroscopy, the single row anchor was used to reconstruct the rotator cuff tear. After the operation, the California University shoulder score system （UCLA） was used for the follow-up. Results All the wounds achieved primary healing. No joint infection and nerve injury occurred. According to imaging examination, there was no slippage of the anchor and recurrence of rotator cufftear. The follow-up time ranged flom 6 to 36 months with an average of 23 months. The postoperative pain symptoms were relieved effectively, and the shoulder function recovered well. According to the UCLA score system, the results were rated as excellent in 10 cases, good in 2 cases and poor in 1 case. The rate of patient satisfaction was 100%. Conclusion Arthroscopic single row anchor for reconstruction of small and medium rotator cuff tear has the advantages of simple operation, small trauma, short operation time, light postoperative pain, quick function recovery, relatively low cost. It is an ideal treatment method for repair of such injuries.