After the improvement in arthroscopic shoulder surgery,superior labrum anterior to posterior(SLAP)tears are increasingly recognized and treated in persons with excessive overhead activities like throwers.Several poten...After the improvement in arthroscopic shoulder surgery,superior labrum anterior to posterior(SLAP)tears are increasingly recognized and treated in persons with excessive overhead activities like throwers.Several potential mechanisms for the pathophysiology of superior labral tears have been proposed.The diagnosis of this condition can be possible by history,physical examination and magnetic resonance imaging combination.The treatment of type 1 SLAP tears in many cases especially in older patients is non-operative but some cases need arthroscopic intervention.The arthroscopic management of type 2 lesions in older patients can be biceps tenodesis,but young and active patients like throwers will need an arthroscopic repair.The results of arthroscopic repair in older patients are not encouraging.The purpose of this study is to perform an overview of the diagnosis of the SLAP tears and to help decision making for the surgical management.展开更多
To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the sho...To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the shoulder.There were four tests,including Kibler anterior sliding test,Liu crank test,O’Brien active compression test and Kim biceps load test Ⅱ.The arthroscopic examination were also performed.The result of the arthroscopic examination was considered as a golden standard,so that we could estimate the diagnosis value of the four tests according to the method of evaluation of diagnosis test on clinical epidemiology,their sensitivity,specificity,positive and negative predictive value,accuracy.Results There were 21 cases diagnosed as SLAP lesions by arthroscopy.The diagnosis value of Kim biceps load test Ⅱ was the highest among the four tests,in which 19 of true positive,59 of true negative,1 of false positive,only 2 of false negative cases;while the sensitivity was 90.48%,specificity was 98.33%,positive predictive value was 95.00%,negative predictive value was 96.72%,and accuracy was 96.30%.However the sensitivity,specificity,positive predicitive value,negative predictive vale and accuracy of Kibler anterior sliding test were 76.19%,96.67%,88.89%,92.06%,91.33%;and those of Liu crank test were 85.71%,93.33%,81.82%,94.92%,91.35%;those of O’Brien active compression test were 80.95%,91.66%,77.27%,93.22%,88.89%.Conclusion Kim Biceps load test Ⅱ may be the best for clinical diagnosis of SLAP lesions of the shoulder.9 refs,4 figs,2 tabs.展开更多
目的:探讨关节镜治疗轻度成人髋臼发育不良(developmental dysphasia of the hip,DDH)的可行性和临床疗效。方法:回顾性研究于2011年5月~2014年7月在我科因DDH行关节镜手术治疗并最终获得随访的27例患者。平均年龄39.6±10.1岁(21~5...目的:探讨关节镜治疗轻度成人髋臼发育不良(developmental dysphasia of the hip,DDH)的可行性和临床疗效。方法:回顾性研究于2011年5月~2014年7月在我科因DDH行关节镜手术治疗并最终获得随访的27例患者。平均年龄39.6±10.1岁(21~59岁);男2例,女25例;左髋11例,右髋16例。本组仅收集符合Perner分型Ⅰ度,即轻度髋臼发育不良的患者,测量每位患者的外侧中心边缘角(LCE角)和股骨头覆盖率。手术在髋关节镜下进行,主要操作包括髋臼盂唇损伤的修整或缝合,髋臼或股骨头软骨损伤的清理。应用改良的髋关节Harris评分对术后疗效进行评价,同时对患者进行满意度评估。结果:27例患者从起病到手术时间为4个月到10年,平均21.6±32.3个月。随访时间33.2±9.6个月(21~53个月)。LCE角为19.8°±6.2°(13.1°~27.7°),股骨头覆盖率为67.4%±6.1%(57.4%~75.0%)。手术中证实,27例患者均存在盂唇损伤,9例行盂唇缝合术,18例行盂唇修整术;8例髋臼和股骨头软骨均无损伤,19例髋关节负重区的股骨头或/和髋臼软骨损伤,行软骨病灶清理术。Harris评分由术前的66.9±12.2分(45~90分)增加到术后的90.1±5.1分(86~100分),P<0.001。患者满意度评估中,21例(77.8%)非常满意,4例(14.8%)满意,2例(7.4%)一般。结论:髋关节镜下治疗轻度成人髋臼发育不良可以显著改善患者的髋关节症状和功能,减缓髋关节骨关节病进展,是一项安全、有效、微创的技术。展开更多
文摘After the improvement in arthroscopic shoulder surgery,superior labrum anterior to posterior(SLAP)tears are increasingly recognized and treated in persons with excessive overhead activities like throwers.Several potential mechanisms for the pathophysiology of superior labral tears have been proposed.The diagnosis of this condition can be possible by history,physical examination and magnetic resonance imaging combination.The treatment of type 1 SLAP tears in many cases especially in older patients is non-operative but some cases need arthroscopic intervention.The arthroscopic management of type 2 lesions in older patients can be biceps tenodesis,but young and active patients like throwers will need an arthroscopic repair.The results of arthroscopic repair in older patients are not encouraging.The purpose of this study is to perform an overview of the diagnosis of the SLAP tears and to help decision making for the surgical management.
文摘To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the shoulder.There were four tests,including Kibler anterior sliding test,Liu crank test,O’Brien active compression test and Kim biceps load test Ⅱ.The arthroscopic examination were also performed.The result of the arthroscopic examination was considered as a golden standard,so that we could estimate the diagnosis value of the four tests according to the method of evaluation of diagnosis test on clinical epidemiology,their sensitivity,specificity,positive and negative predictive value,accuracy.Results There were 21 cases diagnosed as SLAP lesions by arthroscopy.The diagnosis value of Kim biceps load test Ⅱ was the highest among the four tests,in which 19 of true positive,59 of true negative,1 of false positive,only 2 of false negative cases;while the sensitivity was 90.48%,specificity was 98.33%,positive predictive value was 95.00%,negative predictive value was 96.72%,and accuracy was 96.30%.However the sensitivity,specificity,positive predicitive value,negative predictive vale and accuracy of Kibler anterior sliding test were 76.19%,96.67%,88.89%,92.06%,91.33%;and those of Liu crank test were 85.71%,93.33%,81.82%,94.92%,91.35%;those of O’Brien active compression test were 80.95%,91.66%,77.27%,93.22%,88.89%.Conclusion Kim Biceps load test Ⅱ may be the best for clinical diagnosis of SLAP lesions of the shoulder.9 refs,4 figs,2 tabs.
文摘目的:探讨关节镜治疗轻度成人髋臼发育不良(developmental dysphasia of the hip,DDH)的可行性和临床疗效。方法:回顾性研究于2011年5月~2014年7月在我科因DDH行关节镜手术治疗并最终获得随访的27例患者。平均年龄39.6±10.1岁(21~59岁);男2例,女25例;左髋11例,右髋16例。本组仅收集符合Perner分型Ⅰ度,即轻度髋臼发育不良的患者,测量每位患者的外侧中心边缘角(LCE角)和股骨头覆盖率。手术在髋关节镜下进行,主要操作包括髋臼盂唇损伤的修整或缝合,髋臼或股骨头软骨损伤的清理。应用改良的髋关节Harris评分对术后疗效进行评价,同时对患者进行满意度评估。结果:27例患者从起病到手术时间为4个月到10年,平均21.6±32.3个月。随访时间33.2±9.6个月(21~53个月)。LCE角为19.8°±6.2°(13.1°~27.7°),股骨头覆盖率为67.4%±6.1%(57.4%~75.0%)。手术中证实,27例患者均存在盂唇损伤,9例行盂唇缝合术,18例行盂唇修整术;8例髋臼和股骨头软骨均无损伤,19例髋关节负重区的股骨头或/和髋臼软骨损伤,行软骨病灶清理术。Harris评分由术前的66.9±12.2分(45~90分)增加到术后的90.1±5.1分(86~100分),P<0.001。患者满意度评估中,21例(77.8%)非常满意,4例(14.8%)满意,2例(7.4%)一般。结论:髋关节镜下治疗轻度成人髋臼发育不良可以显著改善患者的髋关节症状和功能,减缓髋关节骨关节病进展,是一项安全、有效、微创的技术。
