关节镜下治疗大型肩袖撕裂

目的探讨肩关节镜下治疗大型肩袖撕裂的方法和疗效。方法对34例大型肩袖撕裂患者在关节镜下行单排或双排FastTakII锚钉止点重建术。应用美国肩肘外科医师协会评价系统（ASES）和加利福尼亚大学洛杉矶分校（UCLA）肩关节标准评分。结果34例均获随访，时间4．5～40（7．7±2．4）个月。术后患肩在主动上举、内收、后伸、外展、外旋和内旋6个方向的活动度较术前均有改善（P〈0．05）；患肩完成10项13常活动能力：术前为8．45分±O．97分，术后提高至24．60分±1．21分（P〈0．05）；ASES和UCLA评分：术前分别为24．64分±2．44分和8．06分±1．47分，术后分别提高至71．15分±1．28分和21．77分±1．16分（P〈0．05）；VAS评分：术前为7．18分±2．33分，术后为3．43分±1．75分（P〈0．05）。结论肩关节镜下肩袖重建手术微创治疗优势显著，3～5个作业通道和专业化手术器械的合理交替配合操作能满足大型肩袖撕裂止点重建需求，经镜下双排或单排锚钉重建后的大型损伤肩袖稳定性良好，肩关节功能改善明显。

Arthroscopic repair in treatment of large rotator cuff tear

Objective To study the methods and clinical outcomes of arthroscopic repair for large rotator cuff tear. Methods 34 cases of large rotator cuff tear underwent arthroseopic repair of single or double row FastTak II anchor nails. The clinical outcome was assessed by the Rating Scale of the American Shoulder and Elbow Surgeons （ASES） and University of California Los Angeles （UCLA） scoring system. Results All patients got follow up in this study. The follow-up periods averaged 4. 5 -40 （7. 7± 2.4 ） months. The range of shoulder motion got better after arthro- scopic treatment and the preoperative and end follow-up function scores were 8.45 ± 0.97 vs 24. 60 ± 1.21 （ P 〈 O. 05 ）. The preoperative and end follow-up ASES scores were 24. 64 ± 2.44 vs 71.15± 1.28. The preoperative and end follow-up UCLA scores were 8.06 ± 1.47 vs 21.77 ± 1.16 （P 〈0. 05）. The preoperative and end follow-up visu- al analog scale （VAS） scores were 7. 18 ±2. 33 vs 3.43± 1.75 （ P 〈 0. 05 ）. Conclusions Arthroscopic rotator cuff repair is an effective and advantagous method for the treatment of large rotator cuff tear. Three to five operation chan- nels and specialized surgical instruments can satisfy the treatment of large rotator cuff tear perfectly. Arthroscopic re- pair of single or double row FastTak II anchor nails is minimally invasive and stable, leading to faster return of full o- verhead function of the shoulder joint.