镜下缝线锚钉修复治疗肩关节习惯性脱位并盂唇撕裂对肩关节功能的影响

Effect of Repair of Suture Anchor Under Microscope for Habitual Dislocation of Shoulder Joint and Laceration of Glenoid Lip on Shoulder Function

目的探讨镜下缝线锚钉修复治疗肩关节习惯性脱位并盂唇撕裂对肩关节功能的影响。方法回顾性分析2017年3月至2021年6月本院收治的97例肩关节习惯性脱位并盂唇撕裂患者临床资料,将通过传统开放性手术治疗的患者归为开放组(n=45),应用镜下缝线锚钉修复治疗的患者作为镜下组(n=52)。观察并比较两组患者术前、随访6个月、末次随访时肩关节功能、肩关节活动度、疼痛程度以及临床疗效和并发症发生率。结果随访6个月、末次随访时两组美国肩肘外科医师学会(ASES)评分、美国加州洛杉矶大学肩关节(UCLA)评分以及外展90°外旋、前屈上举、外旋、内旋活动度均高于术前(P<0.05),末次随访时均高于随访6个月时(P<0.05),且镜下组随访6个月、末次随访时上述指标均高于开放组(P<0.05);两组随访6个月、末次随访时视觉模拟评分(VAS)均低于术前(P<0.05),末次随访时均低于随访6个月时(P<0.05),且镜下组随访6个月、末次随访时VAS评分低于开放组(P<0.05);镜下组优良率高于开放组(P<0.05);镜下组并发症发生率低于开放组(P<0.05)。结论与传统开放性手术比较,镜下缝线锚钉修复治疗肩关节习惯性脱位并盂唇撕裂的疗效更佳,更有助于改善肩关节功能,提升关节活动度,减轻疼痛,且并发症发生率较低。

Objective To investigate the effect of repair of suture anchor under microscope on shoulder function in the treatment of habitual dislocation of shoulder joint and glenoid tear.Method Retrospective analysis was made on the clinical data of 97 patients with habitual dislocation of shoulder joint and laceration of glenoid lip admitted to our hospital from March 2017 to June 2021.The patients who were treated with traditional open surgery were divided into open group(n=45),and the patients who were treated with repair of suture anchor under microscope were divided into under microscope group(n=52).The function of shoulder joint,range of motion of shoulder joint,degree of pain before operation,during 6 months of follow-up and at the last follow-up,clinical efficacy and incidence of complications were observed and compared between the two groups.Results The American Association of Shoulder and Elbow Surgeons(ASES)score,American University of California Los Angeles(UCLA)score,and the joint range of motion of abduction 90°external rotation,forward bending and lift,external rotation and internal rotation at 6 months follow-up and the last follow-up in the two groups were higher than those before operation(P<0.05),and the last follow-up were higher than those of the follow-up for 6 months(P<0.05),and the above indexes at 6 months of follow-up and the last follow-up in the under microscope group were higher than those in the open group(P<0.05).The visual analog score(VAS)at the follow-up of 1 months and the last follow-up in the two groups were lower than those of the before operation(P<0.05),and the last follow-up were lower than those of the follow-up for 1 months(P<0.05),and the VAS score at 1 months of follow-up and the last follow-up in the under microscope group were lower than those in the open group(P<0.05).The excellent and good rate of the under microscope group were higher than those of the open group(P<0.05).The incidence of complications in the under microscope group were lower than those in the open group(P<0.05).Conclusion Compared with the traditional open surgery,the effect of repair of suture anchor under microscope is better in the treatment of habitual dislocation of shoulder joint and laceration of glenoid lip,which improves the function of shoulder joint,improves joint mobility,alleviates pain,and reduces the incidence of complications.