肱二头肌长头腱切断治疗老年肩袖损伤研究

Case-control study on arthroscopic rotator cuff repair with long head of biceps tendon cut-off for rotator cuff injury

目的比较肱二头肌肌腱切断治疗老年可修复性肩袖损伤的临床疗效进行评估,从而为老年肩袖损伤的临床治疗提供参考和指导。方法选取本院2018年1月至2019年6月采用肩关节镜治疗肩袖损伤老年患者60例,根据是否行肱二头肌长头腱切断分为两组:切断组(关节镜下肩袖修补并肱二头肌长头腱切断术)30例,对照组(单纯关节镜下肩袖修补)30例。术前和术后运用视觉模拟(VAS)评分法、Constant-murley(CMS)评分和美国加利福尼亚大学洛杉矶分校(UCLA)评分进行疼痛和功能评定。结果两组术后3个月、6个月及12个月VAS评分较术前均有改善;对照组在术后6个月时较术后3个月改善不大,组内比较无统计学差异;患者术后3个月、6个月、12个月的CMS及UCLA功能评分与术前比较都有明显提高;通过组内CMS评分中外展和前屈功能比较,术后1年和术前都有明显提高,组间对比术后1年两组无明显差异。结论针对老年肩袖损伤患者,肩关节镜下肱二头肌长头腱切断对肩关节功能无明显影响,有效降低术后残留疼痛,该手术方式值得在临床推广和使用。

Objective To compare the clinical efficacy of biceps brachii tendon transection in the treatment of rotator cuff injury in the elderly,so as to provide reference and guidance for the clinical treatment of rotator cuff injury in the elderly.Methods From January 2018 to June 2019,60 elderly patients with rotator cuff injury in our hospital were selected and divided into two groups according to whether to cut the long head tendon of biceps:30 cases in the amputation group(rotator cuff repair under arthroscopy and long head tendon resection of biceps)and 30 cases in the control group(simple arthroscopic rotator cuff repair).Visual analogue scale(VAS),Constant Murley(CMS)score and UCLA score were used to assess pain and function before and after operation.Results The VAS scores of the two groups at 3 months,6 months and 12 months after operation were improved compared with those before operation.There was no significant difference in the control group at 6 months after operation compared with 3 months after operation,and there was no statistical difference within the group.The CMS and UCLA function scores of the patients after 3 months,6 months and 12 months after operation were significantly improved compared with those before operation.With the comparison of abduction and flexion function in the CMS score within the group,there was a significant improvement after 1 year and before the operation,and had no significant difference between the two groups one year after operation.Conclusion For the elderly patients with rotator cuff injury,the long head of biceps tendon transection under arthroscopy has no significant effect on shoulder joint function,and can effectively reduce postoperative residual pain,which is worthy of clinical promotion and use.