关节镜下缝线桥修补联合手法松解治疗肩袖撕裂合并关节粘连的效果

Effect of arthroscopic suture bridge repair combined with manual release on rotator cuff tear complicated by joint adhesion

目的 研究关节镜下缝线桥修补联合手法松解治疗肩袖撕裂合并关节粘连的效果。方法 选取2020年1月至2023年1月新里程安钢总医院收治的肩袖撕裂合并关节粘连患者82例,按照随机数字表法分为试验组和对照组,每组41例。对照组采用关节镜下双排缝合术联合手法松解治疗,试验组采用关节镜下缝线桥修补联合手法松解治疗。比较两组围术期指标、视觉模拟评分法(VAS)评分、肩关节活动度(肩关节前屈、外展、内旋、外旋活动度)、肩关节功能(SST)评分及并发症发生率。结果 与对照组比较,试验组术中出血量少,手术时间、住院时间短(P<0.05)。与对照组比较,试验组术后7 d、术后1个月、术后2个月VAS评分低(P<0.05)。与对照组比较,试验组术后2个月肩关节前屈、外展、内旋、外旋活动度大(P<0.05)。与对照组比较,试验组术后2个月SST评分高(P<0.05)。试验组并发症发生率[4.88%(2/41)]与对照组[14.63%(6/41)]比较,差异未见统计学意义(P>0.05)。结论 关节镜下缝线桥修补联合手法松解治疗肩袖撕裂合并关节粘连能明显减少术中出血量,缩短手术时间和住院时间,减轻机体疼痛,改善患者肩关节功能及活动度,且术后并发症少。

Objective To investigate the clinical effect of arthroscopic suture bridge repair combined with manual release on rotator cuff tear complicated by joint adhesion.Methods A total of 82 patients with rotator cuff tear complicated by joint adhesion in New Mile Angang General Hospital from January 2020 to January 2023 were selected and divided into experiment group and control group according to random number table,with 41 cases in each group.The control group was treated with arthroscopic double-row suture combined with manual release,and the experiment group was treated with arthroscopic suture bridge repair combined with manual release.The perioperative indexes,visual analogue scale(VAS) scores,shoulder range of motion(shoulder flexion,abduction,internal rotation and external rotation range of motion),simple shoulder test(SST) scores and incidences of complications were compared between the two groups.Results Compared with the control group,the experiment group had less blood loss,shorter operation time and shorter hospital stay(P<0.05).Compared with the control group,the VAS scores of the experiment group were lower at 7 days,1 month and 2 months after surgery(P<0.05).Compared with the control group,the shoulder flexion,abduction,internal rotation and external rotation of the experiment group were more active at 2 months after surgery(P<0.05).Compared with control group,the SST score of experiment group was higher at 2 months after operation(P<0.05).There was no significant difference in the incidence of complications between the experiment group(4.88%,2/41) and the control group(14.63%,6/41)(P>0.05).Conclusions Arthroscopic suture bridge repair combined with manual release in the treatment of rotator cuff tears with joint adhesion can significantly reduce the amount of bleeding during the operation,shorten the operation time and hospital stay,and reduce body pain,the function and range of motion of shoulder joint are improved,and the postoperative complications are less.