关节镜下双排缝合桥有结与无结修复治疗老年肩袖损伤的效果比较

Comparison of the effects of arthroscopic repair of double-row suture bridge with and without knot on elderly rotator cuff injury

目的比较关节镜下双排缝合桥有结与无结修复治疗老年肩袖损伤的效果。方法选择2019年10月至2022年10月就诊于平煤神马医疗集团总医院的100例老年肩袖损伤患者为研究对象,按照随机数字表法分为对照组与研究组,每组50例。所有患者均采用关节镜下双排缝合桥技术,对照组予以有结修复,研究组予以无结修复。比较两组手术时间、视觉模拟评分法(VAS)评分、UCLA评分、Constant-Murley评分及AESE评分、术后关节僵硬和肩袖再撕裂发生率。结果研究组手术时间短于对照组,差异有统计学意义(P<0.05)。两组术后1周及术后3个月VAS评分均明显低于术前,且研究组低于对照组,术后两组UCLA评分、Constant-Murley评分及AESE评分均明显高于术前,且研究组重-巨大撕裂患者UCLA评分、Constant-Murley评分及AESE评分均高于对照组重-巨大撕裂患者,差异有统计学意义(P<0.05)。研究组术后肩袖再撕裂发生率低于对照组,差异有统计学意义(P<0.05)。结论关节镜下双排缝合桥无结修复在老年肩袖损伤治疗中疗效显著,有助于缩短手术时间,减轻术后疼痛,提高关节功能,减少肩袖再撕裂的风险。

Objective To compare the effects of arthroscopic knotted and no-knotted double-row suture-bridge repair on rotator cuff tears in the elderly.Methods One hundred elderly patients with rotator cuff injury admitted to Pingmei Shenma Medical Group General Hospital from October 2019 to October 2022 were selected as the study objects,and they were randomly divided into the control group and the study group,with 50 cases in each group.All patients were treated with arthroscopic double-row suture bridge technique.The control group was repaired with knots,and the study group was repaired without knots.The operation time,Visual analog scoring(VAS),UCLA,Constant-Murley and AESE scores,the incidence of joint stiffness and rotator cuff retear were compared between the two groups.Results The operation time of the study group was shorter than that of the control group(P<0.05).The VAS scores of the two groups decreased significantly at 1 week and 3 months after operation,and the VAS scores of the study group were lower than those of the control group(P<0.05).Compared with preoperative scores,the UCLA,Constant-Murley and AESE scores of the two groups were significantly improved after operation(P<0.05).The UCLA,Constant-Murley and AESE scores of patients with severe-giant tears in the study group were higher than those in the control group(P<0.05).The incidence of postoperative rotator cuff retear in the study group was lower than that in the control group(P<0.05).Conclusions Arthroscopic double-row suture-bridge knotless repair is effective on rotator cuff tears in the elderly,which can shorten the operation time,relieve postoperative pain,improve joint function,and reduce the risk of rotator cuff retear.