关节镜下肩袖肱骨止点内移技术与传统技术治疗巨大肩袖撕裂的疗效比较

A comparative study of technique of humeral ending insertion of rotator cuff under arthroscopy and traditional techniques in the treatment of giant rotator cuff tear

目的:探讨关节镜下肩袖肱骨止点内移技术的可行性,为治疗巨大肩袖撕裂提供一种方案。方法:自2014年2月至2018年4月行手术治疗巨大肩袖撕裂患者40例,分成2组,研究组20例,男8例,女12例,年龄42~82(57.55±8.90)岁,病程1 h^2年;采用肩袖在肱骨头处止点内移,重建完整肩袖技术治疗巨大肩袖撕裂;对照组20例,男10例,女10例,年龄45~75(57.75±9.10)岁,病程1 h^5年,采用传统清理后部分缝合肩袖或原位高张力下缝合技术治疗巨大肩袖撕裂。采用VAS评分、Constant评分、UCLA评分评价两组临床疗效。结果:40例患者均获随访,时间12~14个月。两组术后VAS评分、Constant评分、UCLA评分与术前比较均明显改善(P<0.05);研究组在VAS评分、Constant评分和UCLA评分及疗效明显优于对照组(P<0.05)。结论:关节镜下肩袖肱骨止点内移治疗巨大肩袖撕裂在肩关节疼痛缓解,功能改善满意,治疗巨大肩袖撕裂是一种可行的方案。

Objective:To explore the feasibility of arthroscopic humeral ending insertion of rotator cuff,and to provide a scheme for the treatment of giant rotator cuff tears.Methods:From February 2014 to April 2018,40 patients with giant rotator cuff tears were operated on and divided into two groups.The study group consisted of 20 patients,including 8 males and 12 females,aged 42 to 82(57.55±8.90)years,with a course of 1 h to 2 years;the treatment of giant rotator cuff tears was carried out by using the technique of rotator cuff moving inward at the humeral head stop and reconstructing complete rotator cuff.The control group consisted of 20 patients,including 10 males and 10 females,aged 45 to 75(57.75±9.10)years,with a course of 1 h to 5 years;after traditional cleaning,part of the rotator cuff was sutured or in-situ high tension suture was used to treat the huge rotator cuff tear.The clinical effect of the two groups was evaluated by VAS,constant and UCLA.Results:All patients were followed up for 12 to 14 months.The VAS,Constant score,UCLA score before operation of two groups were significantly improved compared with those before operation(P<0.05);the VAS,Constant score,UCLA score and excellent effect of the study group were significantly better than those of the control group(P<0.05).Conclusion:Arthroscopic transposition of rotator cuff and humerus ending insertion is a feasible method for the treatment of giant rotator cuff tears,which relieves shoulder pain and improves function satisfactorily.