肩峰指数、关节盂倾斜度与肩关节镜手术后功能恢复的关系

Relationships between Acromion Index,Glenoid Inclination and Functional Recovery After Arthroscopic Surgery

目的探讨肩峰指数、关节盂倾斜度与肩关节镜手术后功能恢复的关系。方法选取2016年9月至2018年9月在北京中医药大学东方医院和北京中医药大学东直门医院骨科行肩关节镜手术的50例患者作为研究对象,其中男27例,女23例;年龄30~75岁,平均年龄(55.70±13.04)岁;左肩21例,右肩29例。术前及术后12个月均接受X线摄片、MRI及CT检查,并采用肩关节Constant-Murley评分及加州大学洛杉矶分校(University of California Los Angeles,UCLA)评分,评估患者肩关节功能情况。采用Pearson检验分析影像学检查相关指标,分析肩关节盂形态学参数分别与Constant-Murley、UCLA评分的相关关系。结果术后12个月的肩峰指数、肩峰角、喙肩韧带厚度、肩锁关节骨赘高度及肩关节盂高度、宽度、倾斜角均显著小于术前(P<0.05),肩肱间距及肩关节盂扭转角明显大于术前(P<0.05)。术后12个月Constant-Murley及UCLA评分均显著高于术前(P<0.05)。肩峰指数、肩峰角、喙肩韧带厚度、肩锁关节骨赘高度及肩关节盂高度、宽度、倾斜角分别与Constant-Murley、UCLA评分呈负相关(P<0.05),肩肱间距及肩关节盂扭转角分别与Constant-Murley、UCLA评分呈正相关(P<0.05)。结论肩峰指数、关节盂倾斜度均与Constant-Murley、UCLA评分密切相关,可作为反映肩关节镜手术后功能恢复的有效指标。

Objective To explore the relationships between acromion index,glenoid inclination and functional recovery after arthroscopic surgery.Methods From September 2016 to September 2018,50 patients who underwent shoulder arthroscopic surgery in Orthopaedic Department of Oriental Hospital of Beijing University of traditional Chinese medicine and Dongzhimen Hospital of Beijing University of traditional Chinese Medicine were selected as the study objects.There were 27 males and 23 females,with an average age of(55.70±13.04)years(range 30~75 years),including left shoulder 21 cases,right shoulder 29 cases.X-ray,magnetic resonance imaging(MRI)and electronic computed tomography(CT)were performed before and 12 months after operation;Constant-Murley score and University of California,Los Angeles(UCLA)score were used to evaluate the function of shoulder joint.And Pearson’s test was used to analyze the correlations between the imaging indexes,morphological parameters of glenoid and Constant-Murley,UCLA scores.Results At 12 months after operation,the acromion index,acromial angle,coracoacromial ligament thickness,acromioclavicular osteophyte height,glenoid height,width and inclination angle were significantly lower than those before operation(P<0.05),and the scapulohumeral space and glenoid rotation angle of shoulder joint were significantly greater than those before operation(P<0.05).The scores of Constant-Murley and UCLA at 12 months after operation were significantly higher than those before operation(P<0.05).The acromion index,acromial angle,coracoacromial ligament thickness,acromioclavicular osteophyte height,glenoid height,width and inclination angle were negatively correlated with the Constant-Murley and UCLA scores(P<0.05),and the scapulohumeral space and glenoid rotation angle of shoulder joint were positively correlated with the Constant-Murley and UCLA scores(P<0.05).Conclusion Acromion index and glenoid inclination are closely related to Constant-Murley and UCLA scores,which may be an effective index to reflect the functional recovery after arthroscopy.