关节镜下完全清理钙化灶术治疗肩袖钙化性肌腱炎效果观察

The effect of arthroscopic total calcification in the treatment of rotator cuff calcified tendonitis

目的探讨关节镜下完全清理钙化灶术治疗肩袖钙化性肌腱炎的临床效果。方法回顾性分析自2013年1月至2018年2月收治的26例肩袖钙化性肌腱炎患者的临床资料,均行关节镜微创手术治疗,术中配合透视对钙化灶进行完全清理。记录并比较患者术前、术后美国肩肘协会评分系统(ASES)评分、疼痛视觉模拟评分(VAS)、Constant-Murley评分、美国加州大学肩关节评分系统(UCLA)评分。结果与术前比较,患者术后ASES评分、Constant-Murley评分、UCLA评分显著升高,VAS评分显著降低,差异均有统计学意义(P<0.05)。患者术后复查影像学检查,提示肩关节内钙化灶基本无残留,且术后未出现神经、血管损伤等并发症。术后3个月,复查未见明显钙化灶,且术后缝合肩袖后,未出现肩袖撕裂症状,指导患者进行适度功能锻炼,满意度高。结论关节镜下完全清理钙化灶治疗肩袖钙化性肌腱炎的临床疗效显著,术后患者满意度高,能明显改善患者肩关节疼痛伴活动受限症状。

Objective To evaluate the effect of arthroscopic complete calcification in the treatment of rotator cuff calcified tendonitis.Methods A retrospective study was performed on 26 cases of patients with rotator cuff calcified tendonitis who were admitted from January 2013 to February 2018.All patients were treated with arthroscopy,and the calcified lesions were completely cleaned with fluoroscopy.The American association of shoulder-elbow scoring system(ASES)score,visual analogue score(VAS),Constant-Murley score and University of California at Los Angeles shoulder score(UCLA)were recorded and compared before and after surgery.Results Compared with the preoperative comparison,the postoperative ASES score,Constant-Murley score and UCLA score of the patients were significantly increased,and the VAS score was significantly reduced,with statistically significant differences(P<0.05).Postoperative imaging examination showed that there was basically no residual calcification in the shoulder joint,and no postoperative complications such as nerve and blood vessel injury.Three months after the operation,no obvious calcification was found in the reexamination,and no rotator cuff tear was observed after the suture of rotator cuff.The patients were instructed to conduct moderate functional exercise after the operation,and the postoperative satisfaction was high.Conclusion Complete removal of calcified foci under arthroscopy for the treatment of rotator cuff calcified tendonitis has a significant clinical effect,with high postoperative satisfaction,and can significantly improve the symptoms of shoulder joint pain with limited mobility.