肩关节镜下无结与有结缝线桥技术治疗肩袖撕裂术后的疗效对比分析

目的探讨无结与有结的缝线桥技术治疗肩袖撕裂术后临床疗效的比较。方法选取2019年3月至2021年3月本院骨科收治的肩关节镜肩袖修补的患者82例,根据术中内排缝线是否打结分组,其中无结组43例,有结组39例,比较两组间一般资料,术后肩关节功能评分以及再撕裂率的差异,线性回归分析肩关节功能的改善与手术方式的关联性。结果两组患者术后3个月及12个月的肩关节功能评分无显著差异,无结组发生不愈合率高于有结组,但无统计学差异(P>0.05),在手术时间、住院时间内及术后1d的VAS评分方面,无结组优于有结组(P<0.05),术后12个月肩关节功能改善值与手术方式的选择无显著的关联性(P>0.05)。结论肩关节镜下采用无结的缝线桥技术与有结的缝线桥技术相比在中期疗效方面无显著差异,在手术时间、术后疼痛方面具有显著的优势,长期的疗效及再撕裂发生率方面的差异有待进一步的观察。

Objective To investigate the clinical and functional outcomes of patients who underwent knotless compared with knotted suturebridge rotator cuff repair.Methods Patients who underwent rotator cuff repair between march 2019 and march 2021 were enrolled in this study,and were grouped by the basis of medial-row knotted or not.The general information,post-operative shoulder function score and post-operative rotator cuff retear rate were compared between the two groups.Linear regression was performed to analysis the correlation between the improvement of shoulder function and surgery option.Results A total of 82 patients were enrolled in this study,with 43 patients underwent knotless suture-bridge rotator cuff repair and 39 patients underwent knotted suture-bridge rotator cuff repair.3 months and 12 months after the operation,there was no significantly difference of the shoulder function scores between the two groups(P>0.05).The post-operative rotator cuff retear rate was higher in the knotless group,with no statistical difference(P>0.05).The knotless group showed better outcome of the length of operation,length of hospitalization and the visual analogue scale(VAS)score after the operation than the knotted group(P<0.05).Linear regression showed that there was no significant correlation between the improvement of shoulder function and surgery option(P>0.05).Conclusion There are no difference of mid-term clinical outcome between knotless and knotted suturebridge rotator cuff repair.The knotless suture-bridge rotator cuff repair is superior to knotted suture-bridge rotator cuff repair in the length of operation and postoperative pain.The comparison of long-term outcome and retear rate requires further study.