关节镜下Mason⁃Allen技术治疗肩胛下肌腱损伤

Clinical Outcomes of Mason⁃Allen Stitches Repair Technique in Treatment of Subscapularis Tendon Tears under Shoulder Arthroscopy

目的探讨关节镜下Mason⁃Allen技术修复肩胛下肌腱损伤的临床疗效。方法回顾性分析2015年5月至2018年12月我院于关节镜下采用Mason⁃Allen技术修复肩胛下肌腱损伤的98例病人的临床资料,其中男75例,女23例,年龄为(56.4±9.6)岁。采用疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分、Constant⁃Murley肩关节评分评估手术前后的肩关节功能,比较手术前后的肩关节活动范围,通过术前及术后6个月的MRI评估肩胛下肌腱的完整性。结果病人随访(12.5±4.0)个月。末次随访时,Constant⁃Murley肩关节评分由术前的(42.11±4.53)分提高至(88.76±6.11)分,ASES评分由(54.70±15.89)分提高至(83.36±11.07)分,VAS评分由(4.92±1.30)分降低至(1.51±1.13)分,肩关节前屈上举由87.26°±16.30°提高至151.28°±17.65°,外展外旋由52.18°±11.41°提高至75.76°±8.68°,内旋由12.30°±4.51°提高至40.50°±3.30°;手术前后数据比较,差异均有统计学意义(P<0.05)。术后6个月,7例(7.1%)经MRI检查确认存在再撕裂。结论关节镜下应用Mason⁃Allen技术治疗肩胛下肌腱损伤,临床疗效改善明显,肌腱完整性良好,是关节镜下修复肩胛下肌腱的一种有效方法。

Objective To evaluate the clinical outcomes of arthroscopic Mason⁃Allen stitches technique in repairing subscapular tendon injury.Methods The clinical data of 98 patients with subscapular tendon injury who were treated with Mason⁃Allen technique under an arthroscope from May 2015 to December 2018 were analyzed retrospectively,including 75 males and 23 females,aged(56.4±9.6)years.The visual analogue scale(VAS),American Shoulder and Elbow Surgeons(ASES)score and Constant⁃Murley shoulder joint score were used to evaluate the shoulder joint function before and after surgery.The range of motion of the shoulder joint before and after surgery was compared.The integrity of the subscapular tendon was evaluated by MRI before and 6 months after surgery.Results The follow⁃up duration was(12.5±4.0)months.At the last follow⁃up,the Constant⁃Murley score increased from 42.11±4.53 to 88.76±6.11,the ASES score increased from 54.70±15.89 to 83.36±11.07,the VAS score decreased from 4.92±1.30 to 1.51±1.13,the shoulder joint flexion and lift increased from 87.26°±16.30°to 151.28°±17.65°,and the abduction and external rotation increased from 52.18°±11.41°to 75.76°±8.68°,internal rotation increased from 12.30°±4.51°to 40.50°±3.30°,the data before and after operation were statistically significant(P<0.05).At 6th month after operation,7 cases(7.1%)were confirmed to have re⁃tearing by MRI.Conclusion Arthroscopic repair using Mason⁃Allen suture technique in patients who had subscapularis tears have satisfactory clinical outcomes and reliable tendon healing.