关节镜下肩袖肱骨止点内移技术修复巨大肩袖撕裂

Massive rotator cuff tear reparied by arthroscopic rotator cuff humeral insertion shift technique

目的探讨关节镜下肩袖肱骨止点内移技术修复巨大肩袖撕裂的疗效。方法将关节镜手术治疗的60例巨大肩袖损伤患者采用随机数字表法分为观察组(采用肩袖肱骨止点内移技术,30例)和对照组(采用传统缝线桥技术,30例)。记录并发症发生情况。比较两组疼痛VAS评分、肩关节Constant评分、ASES评分、UCLA评分、肩关节活动度和肩袖再撕裂情况。结果患者均获得随访,时间9~24个月。未发生神经损伤、血管损伤、锚钉脱出、感染等并发症。术后6个月VAS评分、肩关节Constant评分、ASES评分、UCLA评分、肩关节活动度两组较术前均有明显改善(P<0.05),两组间比较差异均无统计学意义(P>0.05)。术后6个月观察组2例发生肩袖再撕裂,少于对照组的9例,差异有统计学意义(P<0.05)。结论关节镜下肩袖肱骨止点内移技术修复巨大肩袖撕裂是一种安全、有效的方法,肩袖再撕裂发生率低,术后短期疗效值得肯定。

Objective To investigate the clinical efficacy of arthroscopic rotator cuff humeral insertion shift in the treatment of patients with massive rotator cuff tear.Methods A total of 60 patients with massive rotator cuff tears who underwent arthroscopic surgery were selected,and divided into observation group and control group according to random number table method,each of 30 patients.In the observation group,arthroscopic humeral insertion shift technique was used,while in the control group,traditional suture bridge technique was used.Postoperative complications of the two groups were recorded.The two groups of patients were compared by pain VAS,shoulder Constant score,ASES score,UCLA score,shoulder range of motion and rotator cuff re-tear.Results All patients were followed up for 9~24 months,without postoperative complications such as nerve injury,vascular injury,anchor pulling out and infection.At 6 months after operation,the VAS,shoulder Constant score,ASES score,UCLA score,shoulder motion range of the two groups were significantly improved,compared with those before operation(P<0.05).There was no significant difference between the two groups(P>0.05).At 6 months after operation,2 cases of rotator cuff re-tear in the observation group were less than 9 cases in the control group,and the difference was statistically significant between the two groups(P<0.05).Conclusions Arthroscopic rotator cuff humeral insertion shift technique is a safe and effective method to repair massive rotator cuff tear,which can reduce the incidence of re-tear,and the short-term postoperative effect is worthy of recognition.