全肩关节镜下两种缝线桥技术治疗肩袖损伤的疗效比较

Efficacy comparison of two kinds of suture bridge technique for rotator cuff injury under total shoulder arthroscopy

目的比较全肩关节镜下两种缝线桥技术治疗肩袖损伤的疗效。方法将86例肩袖损伤患者根据随机数字表法分为观察组(采用全肩关节镜下双滑轮无结缝线桥技术治疗,43例)和对照组(采用全肩关节镜下传统缝线桥技术治疗,43例)。记录两组手术情况、疼痛VAS评分、Constant评分、ASES评分、UCLA评分、肩关节活动度。结果患者均获得随访,时间2~12个月。①手术时间、术中出血量、住院时间:两组比较差异均无统计学意义(P>0.05)。②疼痛VAS评分:两组术后1、2个月均较术前显著降低(P<0.05),两组术后各时间点比较差异均无统计学意义(P>0.05)。③Constant、ASES、UCLA评分:术后2个月两组均较术前明显改善(P<0.05),两组比较差异均无统计学意义(P>0.05)。④肩关节上举、内收、外展、后伸、前屈:术后2个月两组均较术前明显改善(P<0.01),两组比较差异均无统计学意义(P>0.05)。结论全肩关节镜下微创手术治疗肩袖损伤可有效减轻患者疼痛症状,改善肩关节功能,采用双滑轮无结缝线桥技术与传统缝线桥技术治疗效果无明显差异。

Objective To compare the efficacy of two kinds of suture bridge technique in the treatment of rotator cuff injury under total shoulder arthroscopy.Methods The 86 patients with rotator cuff injuries were divided into observation group(43 cases were performed with double-pulley knotless suture bridge technique under total shoulder arthroscopy)and control group(43 cases were treated with conventional suture bridge technique under total shoulder arthroscopy),according to random number scale method.Surgery condition,pain VAS,Constant score,ASES score,UCLA score and shoulder motion were recorded in the two groups.Results All patients were followed up for 2~12 months.①Operation time,intraoperative blood loss and hospital stay:there were no statistical significances between the two groups(P>0.05).②Pain VAS:at 1,2 months after surgery,they were significantly decreased than the preoperation(P<0.05),and there was no statistical significance between the two groups at each time-point after surgery(P>0.05).③Constant scores,ASES score and UCLA scores:at 2 months after surgery,they were significantly improved,compared with those before surgery(P<0.05),and there was no statistical significance between the two groups(P>0.05).④the uplift,adduction,abduction,posterior extension and anterior flexion of the shoulder joint:at 2 months after surgery,they were significantly improved in both groups(P<0.01),and there was no statistical significance between the two groups(P>0.05).Conclusions Minimally invasive surgery under total shoulder arthroscopy for rotator cuff injury can effectively reduce pain symptoms,and improve shoulder joint function.There is no significant difference between the double-pulley knotless suture bridge technique and the conventional suture bridge technique.