Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first c...Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first classification of SLAP lesions was described in 1990, a subdivision in four types existed. The rising comprehension of pathology and pathophysiology in SLAP lesions contributed to increase the types in SLAP classification to ten. Concerning the causative mechanism of SLAP lesions, acute trauma has to be differed from chronic degeneration. Overhead athletes tend to develop a glenohumeral internal rotation deficit which forms the basis for two controversial discussed potential mechanisms of pathophysiology in SLAP lesions: Internal impingement and peel-back mechanism. Clinical examination often remains unspecific whereas soft tissue imaging such as direct or indirect magnetic resonance arthrography has technically improved and is regarded to be indispensable in detection of SLAP lesions. Concomitant pathologies as Bankart lesions, rotator cuff tears or perilabral cysts should be taken into consideration when planning a personalized therapeutic strategy. In addition, normal variants such as sublabral recess, sublabral hole, Buford complex and other less common variants have to be distinguished. The most frequent SLAP type Ⅱ needs a sophisticated approach when surgical teatment comes into consideration. While SLAP repair is considered to be the standard operative option, overhead athletes benefit from a biceps tenodesis because improved patient-reported satisfaction and higher rate of return to pre-injury level of sports has been reported.展开更多
目的观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。...目的观察关节镜下对V型从前到后上盂唇损伤(superior labral anterior to posterior,SLAP)的复发性肩关节前脱位修复的临床疗效。方法收集我单位2008年3月-2010年12月V型SLAP损伤患者16例,选取同期单纯Bankart损伤病例16例作为对照组。在关节镜下采用可吸收带线锚钉修复盂唇。采用视觉模拟评分(visual analogue scale,VAS)评价疼痛,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分系统和Rowe肩关节评分系统评价关节功能。结果两组患者术后VAS评分、ASES评分和Rowe评分均优于术前(P<0.05),没有脱位复发。两组患者术后结果的差异无统计学意义(P>0.05)。结论对V型SLAP损伤的复发性肩关节前脱位,采用可吸收带线锚钉进行修复可获得良好的临床效果。展开更多
目的探讨合并棘下撞击的髋臼盂唇损伤患者的临床特征并对髋关节镜术后疗效进行评价。方法选择2019年9月至2020年6月我院诊断为合并棘下撞击的髋臼盂唇损伤患者30例,其中男12例,女18例;年龄18~56岁,平均(32.8±10.8)岁。30例患者在...目的探讨合并棘下撞击的髋臼盂唇损伤患者的临床特征并对髋关节镜术后疗效进行评价。方法选择2019年9月至2020年6月我院诊断为合并棘下撞击的髋臼盂唇损伤患者30例,其中男12例,女18例;年龄18~56岁,平均(32.8±10.8)岁。30例患者在髋关节镜下行盂唇修复术、髂前下棘成形术及股骨成形术。术前利用X线片、三维CT和核磁共振等检查明确诊断,术后复查CT了解减压情况。选择疼痛视觉模拟评分(visual analogue scale,VAS),改良Harris髋关节评分(modified Harris hip score,mHHS),日常活动的髋关节功能评分(hip outcome score-activities of daily living,HOS-ADL),体育运动专用髋关节评分(hip outcome score-sports specific subscale,HOS-SSS)评定患者的临床疗效。结果患者均获随访,随访时间8~15个月,平均随访(10.2±5.6)个月。CT提示该组患者均为髂前下棘Ⅱ型增生。患者术前HOS-ADL、HOS-SSS、mHHs评分分别为(50.8±8.3)分、(42.6±10.5)分、(60.5±13.5)分,术后6个月时分别为(86.3±9.6)分、(83.8±8.5)分、(85.6±10.2)分,均较术前显著提高(P<0.001);术前VAS评分为(5.4±3.5)分,术后6个月时为(1.6±0.8)分,较术前显著降低(P<0.001)。结论利用髋关节镜治疗合并棘下撞击的髋臼盂唇损伤患者,能对髂前下棘充分减压并可有效缓解症状,其近期临床疗效良好。展开更多
文摘Surgical treatment of superior labral anterior posterior(SLAP) lesion becomes more and more frequent which is the consequence of evolving progress in both,imaging and surgical technique as well as implants.The first classification of SLAP lesions was described in 1990, a subdivision in four types existed. The rising comprehension of pathology and pathophysiology in SLAP lesions contributed to increase the types in SLAP classification to ten. Concerning the causative mechanism of SLAP lesions, acute trauma has to be differed from chronic degeneration. Overhead athletes tend to develop a glenohumeral internal rotation deficit which forms the basis for two controversial discussed potential mechanisms of pathophysiology in SLAP lesions: Internal impingement and peel-back mechanism. Clinical examination often remains unspecific whereas soft tissue imaging such as direct or indirect magnetic resonance arthrography has technically improved and is regarded to be indispensable in detection of SLAP lesions. Concomitant pathologies as Bankart lesions, rotator cuff tears or perilabral cysts should be taken into consideration when planning a personalized therapeutic strategy. In addition, normal variants such as sublabral recess, sublabral hole, Buford complex and other less common variants have to be distinguished. The most frequent SLAP type Ⅱ needs a sophisticated approach when surgical teatment comes into consideration. While SLAP repair is considered to be the standard operative option, overhead athletes benefit from a biceps tenodesis because improved patient-reported satisfaction and higher rate of return to pre-injury level of sports has been reported.
基金重庆市社会民生科技创新专项项目(CSTC2016shmszx130021)陆军军医大学第一附属医院临床新技术计划项目(SWH2016JSTSYB-54)Supported by the Science and Technology Innovation Special Project of Social People’s Livelihood of Chongqing(CSTC2016shmszx130021)the New Clinical Technology Program of the First Affiliated Hospital of Army Medical University(SWH2016JSTSYB-54)
文摘目的探讨合并棘下撞击的髋臼盂唇损伤患者的临床特征并对髋关节镜术后疗效进行评价。方法选择2019年9月至2020年6月我院诊断为合并棘下撞击的髋臼盂唇损伤患者30例,其中男12例,女18例;年龄18~56岁,平均(32.8±10.8)岁。30例患者在髋关节镜下行盂唇修复术、髂前下棘成形术及股骨成形术。术前利用X线片、三维CT和核磁共振等检查明确诊断,术后复查CT了解减压情况。选择疼痛视觉模拟评分(visual analogue scale,VAS),改良Harris髋关节评分(modified Harris hip score,mHHS),日常活动的髋关节功能评分(hip outcome score-activities of daily living,HOS-ADL),体育运动专用髋关节评分(hip outcome score-sports specific subscale,HOS-SSS)评定患者的临床疗效。结果患者均获随访,随访时间8~15个月,平均随访(10.2±5.6)个月。CT提示该组患者均为髂前下棘Ⅱ型增生。患者术前HOS-ADL、HOS-SSS、mHHs评分分别为(50.8±8.3)分、(42.6±10.5)分、(60.5±13.5)分,术后6个月时分别为(86.3±9.6)分、(83.8±8.5)分、(85.6±10.2)分,均较术前显著提高(P<0.001);术前VAS评分为(5.4±3.5)分,术后6个月时为(1.6±0.8)分,较术前显著降低(P<0.001)。结论利用髋关节镜治疗合并棘下撞击的髋臼盂唇损伤患者,能对髂前下棘充分减压并可有效缓解症状,其近期临床疗效良好。
