“Chinese way”在关节镜下处理巨大肩袖损伤中的作用及临床疗效

The clinical effect of“Chinese way”in the treatment of massive rotator cuff injury under arthroscopy

目的 通过随访评价“Chinese way”在关节镜下处理巨大肩袖损伤中的作用及其治疗效果。方法 回顾性分析2019年1月至2021年9月期间首都医科大学附属北京朝阳医院收治的运用“Chinese way”方法治疗单侧巨大肩袖损伤患者的临床资料,符合纳入标准的患者共42例,其中男性23例、女性19例,年龄45~76岁,平均年龄(57.2±6.3)岁。术中将肱二头肌长头腱转位至足印区,并用一枚内排锚钉尾线缝合固定,然后利用双排锚钉缝合桥技术修补剩余的肩袖断裂部分。统计分析患者术前、术后6个月、1年、2年肩关节的活动度,疼痛及功能评分,并记录患者手术基本情况、术后并发症以及影像学结果评价。结果 本组42例患者均顺利完成手术,术中及术后均未出现严重并发症。所有患者均获得随访,随访时间6~24个月,平均(13.2±4.2)个月。术后6个月以及末次随访时关节活动度、疼痛及功能评分等指标与术前比较,差异均有统计学意义(P<0.01)。X线片检查提示,肩关节退变未见明显进展;磁共振检查提示,6例患者重建的肩袖组织再次撕裂,发生率为14.3%(6/42)。结论 “Chinese way”修补巨大肩袖损伤的方法更能够降低患者疼痛症状、改善关节活动度、恢复关节功能,且并发症及结构失败率更低,值得在临床上推广。

Objective To evaluate the effect of“Chinese way”in the treatment of massive rotator cuff injury under arthroscopy and its therapeutic effect.Methods A retrospective analysis was performed on the clinical data of patients with unilateral massive rotator cuff injury treated by“Chinese way”method in Beijing Chaoyang Hospital from January 2019 to September 2021.A total of 42 patients met the inclusion criteria,including 23 males and 19 females,aged 45-76 years,with an average age of(57.2±6.3)years.During the operation,the long head of biceps tendon was transposed to the footprint area and fixed with an internal row anchor tail suture.The remaining rotator cuff fracture was repaired with a double-row anchor bridge technique.The range of motion,pain and function scores of the shoulder joint were statistically analyzed before surgery,6 months,1 year and 2 years after surgery,and the basic operation situation,postoperative complications and imaging results of the patients were recorded.Results All 42 patients in this group were successfully operated,and no serious complications occurred during or after operation.All patients were followed up for 6-24 months,with an average of(13.2±4.2)months.Anova of single factor repeated measurement showed that there were statistically significant differences in the range of motion,pain and functional score between the six months after surgery and the last follow-up(P<0.01).X-ray examination indicated that there was no obvious progress in shoulder degeneration.Magnetic resonance imaging(MRI)examination revealed retears of reconstructed rotator cuff tissue in 6 patients,with an incidence of 14.3%(6/42).Conclusions The“Chinese way”method for repairing massive rotator cuff injury can reduce pain symptoms,improve range of motion and restore joint function,with lower rate of complications and structural failure,which is worth promoting in clinical practice.