肩关节镜下单排缝合技术与双排缝合桥技术治疗肩袖损伤的临床疗效比较

Comparison of Single Row Suture Technique vs.Double Row Suture Bridge Technique on Rotator Cuff Injury Under Shoulder Arthroscopy

目的比较肩关节镜下单排缝合技术与双排缝合桥技术治疗肩袖损伤的临床疗效。方法本研究采用随机对照设计,共纳入2021年4月至2022年4月于我院就诊的80例肩袖损伤病人,试验组和对照组各40例。试验组采用肩关节镜下双排缝合桥技术,对照组采用肩关节镜下单排缝合技术。病人均在术前、术后3个月、术后6个月、术后1年进行临床及随访评估,记录疼痛视觉模拟量表(VAS)评分、Constant⁃Murley评分、加州大学洛杉矶分校(UCLA)肩关节评分和术后肩袖再撕裂发生率。再分别观察肩袖撕裂直径大小(以3 cm为界)不同的病人中,试验组和对照组之间VAS评分、Constant⁃Murley评分和UCLA评分的差异。结果手术前两组病人的VAS评分、Constant⁃Murley评分和UCLA评分比较,差异无统计学意义(P>0.05)。术后1年随访时,试验组的VAS评分低于对照组,Constant⁃Murley评分和UCLA评分均高于对照组,差异有统计学意义(P<0.05)。对于肩袖撕裂直径<3 cm的病人,试验组和对照组之间的VAS评分、Constant⁃Murley评分和UCLA评分差异无统计学意义(P>0.05);对于肩袖撕裂直径≥3 cm的病人,试验组的VAS评分、Constant⁃Murley评分和UCLA评分均显著优于对照组,差异有统计学意义(P<0.05)。相比对照组,试验组的再撕裂率更低(7.5%vs.17.5%),但差异无统计学意义(P>0.05)。结论相比单排缝合技术,肩关节镜下双排缝合桥技术治疗肩袖损伤具有更优的临床疗效。但对于肩袖撕裂直径<3 cm的病人,单排缝合技术能获得与双排缝合桥技术相似的临床疗效。

Objective To compare the clinical efficacy of single⁃row suture technique and double⁃row suture bridge technique in the treatment of rotator cuff injuries under shoulder arthroscopy.Methods A randomized controlled study was used,and a total of 80 patients with rotator cuff injury in our hospital from April 2021 to April 2022 were included,with 40 patients in the experimental group and 40 patients in the control group.The double⁃row suture bridge technique under shoulder arthroscopy was used in the experimental group,and the single⁃row suture technique under shoulder arthroscopy was used in the control group.All patients were followed up and evaluated before and 3 months,6 months and 1 year after operation.The visual analogue scale(VAS),Constant⁃Murley score,the University of California at Los Angeles(UCLA)shoulder joint score,and postoperative incidence of rotator cuff tear were recorded.The differences in VAS score,Constant⁃Murley score,and UCLA score between the experimental group and the control group in patients with different rotator cuff tear diameters(bounded by 3 cm)were observed.Results There was no significant difference in VAS score,Constant⁃Murley score and UCLA score between the two groups before operation(P>0.05).During the 1⁃year follow⁃up,the VAS score in the experimental group was lower than that in the control group,and the Constant⁃Murley score and UCLA score in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).For patients with rotator cuff tear diameter<3 cm,there was no statistically significant difference in VAS score,Constant⁃Murley score,and UCLA score between the experimental group and the control group(P>0.05).For patients with rotator cuff tear diameter≥3 cm,the VAS score,Constant⁃Murley score,and UCLA score in the experimental group were significantly better than those in the control group,with statistically significant differences(P<0.05).The experimental group had a lower rate of re⁃tearing than the control group(7.5%vs.17.5%),but the difference was not statistically significant(P>0.05).Conclusion The double⁃row suture bridge technique under shoulder arthroscopy has better clinical efficacy than the single⁃row suture technique in the treatment of rotator cuff injuries.However,for patients with rotator cuff tears<3 cm in diameter,the single⁃row suture technique can achieve similar clinical efficacy to the double⁃row suture bridge technique.