关节镜下肩袖修复联合经结节间沟改良锚钉缝合治疗肱二头肌长头腱合并肩袖损伤临床疗效

Clinical efficacy of arthroscopic rotator cuff repair combined with modified intertubercular groove tenodesis for long head of the biceps brachii tendon injury complicated with rotator cuff injury

目的探讨关节镜下肩袖修复联合经肱骨大小结节间沟改良锚钉缝合固定技术治疗肱二头肌长头腱(LHBT)合并肩袖损伤的临床疗效.方法收集31例LHBT合并肩袖损伤患者.记录患者在术前及治疗后18个月的肩关节视觉模拟评分法(VAS)评分、Constant-Murley功能、美国肩肘外科医师评分系统(ASES)评分,观察其肩关节主动活动度及上臂形态变化.结果31例LHBT合并肩袖损伤患者的手术过程均顺利.与术前比较,术后18个月31例患者的VAS评分降低,Constant-Murley功能、ASES评分均升高,肩关节主动活动度(包括外展上举、前屈上举、90°外展位外旋及内旋)均有所改善(P均<0.05).术后3例(10%)患者出现并发症,其中2例肩关节粘连、1例患者上臂出现Popeye畸形,无出现感染、肩袖再撕裂患者.结论关节镜下肩袖修复联合经结节间沟改良锚钉缝合固定LHBT合并肩袖损伤的临床疗效良好.

Objective To evaluate the clinical efficacy of arthroscopic rotator cuff repair combined with modified inter tubercular groove tenodesis in the treatment of long head of biceps brachii tendon(LHBT)injury complicated with rotator cuff injury.Methods Thirty-one LHBT patients complicated with rotator cuff injury were recruited in this study.The visual analogue scale(VAS)score,Constant-Murley shoulder outcome score and American Shoulder and Elbow Surgeons(ASES)score were recorded before and 18 months after treatment.The shoulder active range of motion(ROM)and the morphological changes of the upper arm were observed.Results All 31 LHBT patients successfully completed the surgery.Compared with preoperative data,the VAS score was significantly lower,the Constant-Murley shoulder outcome score and ASES score were significantly higher and the shoulder active ROM(forwarding flexion,abduction,90°abduction external rotation and 90°abduction internal rotation)was remarkably improved(all P<0.05).Postoperative complications occurred in 3 patients(10%)including 2 cases of shoulder joint adhesion and 1 case of Popeye deformity.Neither infection nor rotator cuff tearing occurred.Conclusion Arthroscopic rotator cuff repair combined with modified intertubercular groove tenodesisis an efficacious treatment of LHBT injury complicated with rotator cuff injury.