肩关节镜下清理治疗钙化性冈上肌腱炎的疗效分析

[目的]探讨肩关节镜下清理冈上肌腱内钙化灶治疗钙化性冈上肌腱炎的手术疗效。[方法]自2010年1月～2011年7月对在本院就诊的9例确诊为钙化性冈上肌腱炎的患者行肩关节镜下清理冈上肌腱内钙化灶治疗,术前患者肩关节疼痛剧烈伴活动受限,经正规保守治疗3个月以上无效。术中清理肩峰下间隙,切除炎性滑囊,常规行肩峰成形术,彻底清理冈上肌腱内的钙化灶。术前及术后随访均采用VAS疼痛评分、Constant-Murley评分和X线检查对患者进行评估并做手术前后的对比分析。[结果]术后平均随访6个月,所有患者肩关节疼痛及活动受限均得到明显改善或完全缓解,VAS疼痛评分术前(8.33±1.0)分,术后最后一次复查为(1.44±0.88)分,术前、术后VAS评分差异有统计学意义(P<0.01)。Constant-Murley评分术前为(50.44±10.06)分,术后最后一次复查为(93±4.21)分,术前、术后Constant-Murley评分差异有统计学意义(P<0.01)。术后复查X线片显示冈上肌腱内钙化灶均已完整清除。[结论]关节镜下行冈上肌腱内钙化灶清理,具有手术创伤小、病灶清除彻底、对肩袖及盂肱关节损伤小、术后康复快等优点,临床疗效确切。

Effectiveness of arthroscopic removal of the calcific deposits of calcifying tendonitis of the supraspinatus tendon

[Objective] To evaluate the surgical effectiveness of arthroscopic removal of the calcific deposits of calcifying tendonitis of the supraspinatus tendon.[Methods]From January 2010 to July 2011,arthroscopic treatment was performed in 9 patients who had associated with shoulder pain and limitations in activities of daily living and not responding to conservative treatment for more than 3 months.The patient was treated with an arthroscopic removal of the calcific deposits.VAS pain score,Constant-Murley score and radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 6 months.Pain and functional disability of the shoulder obviously improved or disappeared after the operation.The VAS pain scores and the average Constant-Murley scores improved significantly after the operation.The average VAS pain score was(8.33±1.0) preoperatively and(1.44±0.88) at the last follow-up(P<0.01).The average Constant-Murley score was(50.44±10.06) preoperatively and(93±4.21) at the last follow-up(P<0.01).Radiograph confirmed complete excision of the deposits without recurrence.[Conclusion]Arthroscopic removal of the calcific deposits of the supraspinatus tendons can lead to an excellent clinical outcome without compromising the functional integrity of the rotator cuff tendons.