关节镜下三点定位技术修补肩袖损伤的临床体会

Clinical experience of arthroscopic three-point positioning technique in repairing rotator cuff injury

目的总结关节镜下三点定位技术修补肩袖损伤的临床体会。方法收集2018年1月-2019年6月符合纳入标准的肩袖损伤患者52例,根据手术方法不同分为两组。A组采用传统两点定位技术(n=26),B组采用三点定位技术(n=26),比较两组患者手术时间、视觉模拟评分法(VAS)、美国加州大学(UCLA)肩关节评分、美国肩肘外科协会(ASES)评分、外旋活动度、前屈活动度和外展活动度。结果A组平均手术时间为143.4 min,B组为97.2 min;A组术前VAS评分、UCLA肩关节评分、ASES评分、外旋活动度、前屈活动度和外展活动度分别为(6.9±1.2)分、(14.8±2.3)分、(44.7±7.7)分、(17.4±5.0)°、(83.0±11.1)°和(78.0±11.8)°;术后分别为(1.7±0.7)分、(30.5±2.6)分、(83.3±4.7)分、(38.9±3.7)°、(162.6±8.1)°和(152.4±13.0)°,术前术后比较,差异均有统计学意义(P<0.05);B组术前VAS评分、UCLA肩关节评分、ASES评分、外旋活动度、前屈活动度和外展活动度分别为(7.2±1.0)分、(16.0±2.5)分、(43.0±5.8)分、(16.1±5.2)°、(81.1±12.0)°和(78.3±9.1)°,术后分别为(1.6±0.7)分、(32.8±3.2)分、(84.7±7.4)分、(38.9±4.5)°、(160.7±8.4)°和(145.0±19.8)°,术前术后比较,差异均有统计学意义(P<0.05)。结论虽然传统两点定位技术和三点定位技术治疗肩袖损伤都能取得良好的临床效果,但三点定位技术手术时间更短,肩关节功能恢复更快,更适合肩关节镜初学者。

Objective To summarize the clinical experience of arthroscopic three-point positioning technique in repairing rotator cuff injury.Methods From January 2018 to June 2019,52 patients with rotator cuff injury who met the inclusion criteria were divided into two groups according to different surgical methods.Group A(n=26)used traditional two-point positioning technology,group B(n=26)used three-point positioning technology.Operation time,visual analogue scale(VAS),University of California at LosAngeles(UCLA)shoulder score,American Shoulder Elbow Surgeons(ASES)score,external rotation range of motion,flexion range of motion and abduction range of motion were compared between the two groups.Results The average operation time was 143.4 min in group A and 97.2 min in group B;Preoperative VAS,UCLA,ASES score,external rotation activity,flexion range of motion,outreach activity in group A were(6.9±1.2),(14.8±2.3),(44.7±7.7),(17.4±5.0)°,(83.0±11.1)°and(78.0±11.8)°,the postoperative results were(1.7±0.7),(30.5±2.6),(83.3±4.7),(38.9±3.7)°,(162.6±8.1)°and(152.4±13.0)°,the differences were statistically significant before and after operation(P<0.05).Preoperative VAS,UCLA,ASES score,external rotation activity,flexion range of motion,outreach activity in group B were(7.2±1.0),(16.0±2.5),(43.0±5.8),(16.1±5.2)°,(81.1±12.0)°and(78.3±9.1)°,the postoperative results were(1.6±0.7),(32.8±3.2),(84.7±7.4),(38.9±4.5)°,(160.7±8.4)°,(145.0±19.8)°,the differences were statistically significant before and after operation(P<0.05).Conclusion Although traditional two-point positioning technology and three-point positioning technology can achieve good clinical results in treatment of rotator cuff injury,three-point positioning technology has shorter operation time and faster recovery of shoulder joint function,which is more suitable for beginners of shoulder arthroscopy.