胸锁关节骨性关节炎的关节镜治疗研究

Arthroscopic treatment of sternoclavicular joint osteoarthritis

目的探索关节镜下胸锁关节成形术治疗胸锁关节骨性关节炎的治疗效果。方法7例胸锁关节骨关节炎患者行关节镜下胸锁关节成形术。男3例,女4例;年龄34~62岁,平均43岁。术前和随访评估采用Constant评分和Rockwood胸锁关节评分系统。术后随访1~10个月,平均3.7个月。结果7例患者均于术后2周内恢复术前功能或完全活动。末次随访时,6例无疼痛,1例活动后轻度紧张感。Constant评分中位数从69.6分(62~80分)提高到94.3分(88~96分);Rockwood评分中位数从5.7分(3~8分)提高到14.3分(12~15分)(最多15分)。临床疗效7例全部为优(13~15分)。无并发症,关节稳定性未见异常。结论关节镜下胸锁关节成形术是治疗胸锁关节骨关节炎的一种新的安全有效的治疗方法。

Objective To report the results of a study of 7 patients with osteoarthritis who underwent arthroscopic sternoclavicular arthroplasty in response to conservative treatment.Methods Arthroscopic sternoclavicular arthroplasty was performed in 7 patients with sternoclavicular osteoarthritis.There were 3 males and 4 females.The age ranges from 34 to 62,with an average age of 43.Patients were evaluated before surgery and at follow-up using the Constant score and Rockwood sternoclavicular joint score system.The postoperative follow-up lasted from 1 to 10 months,with an average of 3.7 months.The surgery was performed under general anesthesia without shoulder joint fixation.Results All patients recovered preoperative function or full activity within 2 weeks after operation.At the last follow-up,6 patients had no pain and 1 had mild tension after activity.The median Constant score increased from 69.6(62-80)to 94.3(88-96);The median Rockwood score increased from 5.7(on a scale of 3 to 8)to 14.3(on a scale of 12 to 15)(maximum 15).Clinical efficacy:All 7 cases were excellent(13-15 points).There were no complications,especially no problems with joint stability.Conclusion Arthroscopic sternoclavicular arthroplasty is a new method for the treatment of sternoclavicular osteoarthritis which failed to respond to conservative treatment.