肩关节镜下双排锚钉固定缝合术与单排锚钉固定缝合术治疗巨大肩袖损伤患者的效果比较

Comparison of effects of double-row suture anchor fixation and single-row suture anchor fixation under shoulder arthroscopy in treatment of patients with massive rotator cuff injury

目的:比较肩关节镜下双排锚钉固定缝合术与单排锚钉固定缝合术治疗巨大肩袖损伤患者的效果。方法:回顾性分析2021年3月至2022年10月该院收治的87例巨大肩袖损伤患者的临床资料,依照手术方式不同将其分为对照组(n=43)与观察组(n=44)。对照组行单排锚钉固定缝合术治疗,观察组行双排锚钉固定缝合术治疗。比较两组治疗效果,术前及术后3个月肩关节功能[Constant-Murley肩关节功能(CMS)]评分、疼痛程度[数字分级评分法(NRS)]评分、肩关节活动度(外旋、前屈、外展、后伸、内收),术后1年肩袖再损伤发生率。结果:术后6个月,观察组治疗效果优于对照组,差异有统计学意义(P<0.05);术后3个月,两组CMS评分高于术前,且观察组高于对照组,两组NRS评分低于术前,且观察组低于对照组,差异均有统计学意义(P<0.05);术后3个月,两组肩关节外旋、前屈、外展、后伸、内收活动度均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后1年,观察组肩袖再损伤发生率低于对照组,差异有统计学意义(P<0.05)。结论:双排锚钉固定缝合术治疗巨大肩袖损伤患者可提高治疗效果,减轻疼痛,改善肩关节功能和活动度,降低肩袖再损伤发生率,效果优于单排锚钉固定缝合术治疗。

Objective:To compare effects of double-row suture anchor fixation and single-row suture anchor fixation under shoulder arthroscopy in treatment of patients with massive rotator cuff injury.Methods:The clinical data of 87 patients with massive rotator cuff injury admitted to this hospital from March 2021 to October 2022 were retrospectively analyzed.According to different surgical methods,they were divided into control group(n=43)and observation group(n=44).The control group was treated with single-row suture anchor fixation,while the observation group was treated with double-row suture anchor fixation.The treatment effects,the shoulder joint function[Constant-Murley score(CMS)]scores,the pain degree[numerical rating scale(NRS)]score,the shoulder range of motion(external rotation,anteflexion,abduction,posterior extension,adduction)before and 3 months after the surgery,and the incidence of rotator cuff re-injury 1 year after the surgery were compared between the two groups.Results:Six months after the surgery,the treatment effect of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Three months after the surgery,the CMS scores of the two groups were higher than those before the surgery,and that in the observation group was higher than that in the control group;the NRS scores of the two groups were lower than those before the surgery,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).Three months after the surgery,the ranges of external rotation,anteflexion,abduction,posterior extension,adduction of shoulder joint in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,1 year after the surgery,the incidence of rotator cuff re-injury in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:Double-row anchor fixation and suturing surgery can improve the treatment effect for patients with huge rotator cuff injuries,reduce the pain,improve the shoulder joint function and range of motion,and reduce the incidence of rotator cuff reinjury.Moreover,it is superior to single row suture anchor fixation.