关节镜下松解联合肩袖修复术治疗肩袖损伤合并继发性冻结肩的效果及对肩关节功能的影响

Effect of Arthroscopic Release Combined with Rotator Cuff Repair in the Treatment of Rotator Cuff Injury Combined with Secondary Frozen Shoulder and Its Influence on Shoulder Joint Function

目的:探讨关节镜下松解联合肩袖修复术治疗肩袖损伤合并继发性冻结肩(FS)的效果及对肩关节功能的影响。方法:选择2018年5月-2021年5月九江市第一人民医院收治的92例肩袖损伤合并继发性FS患者,按照随机数字表法将患者分为对照组和观察组,每组46例。观察组采用关节镜下松解联合肩袖修复术治疗,对照组采用手法松解、关节镜下肩袖修复术治疗。比较两组临床指标、肩关节活动度及肩关节功能。结果:观察组术中出血量少于对照组,手术时间及住院时间均短于对照组,差异均有统计学意义(P<0.05)。术前和术后3个月,两组肩关节内旋、外旋、外展及前屈活动度评分比较,差异均无统计学意义(P>0.05)。术后3个月,两组肩关节内旋、外旋、外展及前屈活动度评分均高于术前,差异均有统计学意义(P<0.05)。术前和术后3个月,两组美国肩肘外科协会评分(ASES)评分比较,差异均无统计学意义(P>0.05)。术后3个月,两组ASES评分均高于术前,差异均有统计学意义(P<0.05)。结论:在肩袖损伤合并继发性FS患者中采用手法松解、关节镜下肩袖修复术或是关节镜下松解联合肩袖修复术治疗,均可恢复患者肩关节功能,改善肩关节活动度,但关节镜下松解、肩袖修复术治疗损伤更小,患者术后恢复更快,是一种完全微创治疗术式。

Objective:To investigate the effect of arthroscopic release combined with rotator cuff repair in the treatment of rotator cuff injury combined with secondary frozen shoulder(FS)and its influence on the function of shoulder joint.Method:A total of 92 patients with rotator cuff injury and secondary FS treated in Jiujiang NO.1 People’s Hospital from May 2018 to May 2021 were selected,they were divided into control group and observation group according to random number table method,with 46 cases in each group.The observation group was treated with arthroscopic release combined with rotator cuff repair,while the control group was treated with manual release and arthroscopic rotator cuff repair.The clinical indexes,range of motion and function of shoulder were compared between two groups.Result:The amount of intraoperative blood loss in the observation group was less than that in the control group,and the surgical time and hospitalization time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).Before surgery and 3 months after surgery,there were no statistically significant differences in motion scores of shoulder joint internal rotation,external rotation,abduction and forward flexion between two groups(P>0.05);3 months after surgery,the range of motion scores of shoulder joint internal rotation,external rotation,abduction and forward flexion in both groups were higher than those before surgery,the differences were statistically significant(P<0.05).Before surgery and 3 months after surgery,there were no significant differences in American association of shoulder and elbow surgery(ASES)scores between two groups(P>0.05);3 months after surgery,ASES scores in both groups were higher than those before surgery,the differences were statistically significant(P<0.05).Conclusion:In patients with rotator cuff injury with secondary FS,to use manual release and arthroscopic rotator cuff repair or arthroscopic release combined with rotator cuff repair for the treatment of rotator cuff repair,all can recovery shoulder joint function,improve shoulder joint activity,but under arthroscopy release combined with rotator cuff repair in the treatment of rotator cuff repair damage smaller,patients with postoperative recovery faster,it is a kind of minimally invasive surgery treatment completely.