肩关节镜下双排与单排缝合治疗肩袖撕裂的疗效比较

Comparison of Clinical Outcomes of Double-row and Single-row Fixations in Arthroscopic Rotator Cuff Repair

目的比较肩关节镜下双排与单排缝合治疗肩袖撕裂的临床疗效。方法研究对象为2016年10月至2019年12月治疗的76例肩袖撕裂患者,36例采用双排缝合技术固定(double row,DR),40例采用单排缝合技术固定(single row,SR)。DR组男12例,女24例,平均年龄(58.75±7.32)岁。SR组男23例,女17例,平均年龄(57.57±7.29)岁。比较两组患者的疼痛视觉模拟评分(visual analogue scale,VAS)、加州大学肩关节评分系统(university of California at Los Angeles,UCLA)评分、美国肩肘外科协会评分(rating scale of the American shoulder and elbow surgeons,ASES)。结果所有患者均获随访,随访时间12~23个月,平均(18±3)个月。两组患者的一般资料比较差异均无统计学意义(P>0.05)。与单排缝合组对比,双排缝合组在术后3个月VAS评分更低,差异有统计学意义(P<0.05)。两组患者术前、术后6个月、术后12个月VAS评分比较,差异无统计学意义(P>0.05);两组患者手术前后UCLA评分、ASES评分比较,差异均无统计学意义(P>0.05);两组术后再撕裂等并发症发生率,差异均无统计学意义(P>0.05)。结论肩关节镜治疗肩袖撕裂,双排缝合技术和单排缝合技术均可获得较好的临床疗效,对比单排缝合技术,双排缝合技术改善术后早期疼痛的效果更为显著。

Objective To compare the clinical effects of double-row fixation and single-row fixation in the treatment of rotator cuff tears.Methods From October 2016 to December 2018,76 patients diagnosed with rotator cuff tear were enrolled.36 patients were treated with double row fixation,while 40 patients were treated with single row fixation.There were 12 males and 24 females in the double row group.The mean age was(58.75±7.32)years.There were 23 males and 17 females in the SR group.The mean age was(57.57±7.29)years.The VAS(visual analogue scale),the UCLA(University of California at Los Angeles)shoulder score,the rating scale of ASES(American shoulder and elbow surgeons)were compared between the two groups.Results All the patients were followed up for 12 to 23 months(18±3).There were no significant differences in gender,age,tear type and time between the two groups(P>0.05).The VAS scores of the double row groupwas significantly lowerthan the single row group at 3 months after surgery(P<0.05).There were no significant differences among VAS scores before surgery,6 months and 12 months after surgery(P>0.05).There were no significant differences in the UCLA shoulder score,and ASES score between the two groups before surgery and 3,6,and 12 months after surgery(P>0.05).There were no significant differences in postoperative complication rate and satisfaction between the two groups(P>0.05).Conclusion Arthroscopic double row and single row fixation both can obtain good shoulder function.Compared with single row fixation,the double row fixation is more effective in the early period of postoperational pain relief of rotator cuff tear.