关节镜下肩袖间隙滑移技术在巨大肩袖撕裂中的应用

目的观察关节镜下使用肩袖间隙滑移技术修补巨大肩袖撕裂的临床疗效。方法采用回顾性研究方法,选取2015年1月至2019年3月北京市平谷区医院收治的巨大肩袖撕裂患者42例,按照手术方式不同将患者分为切开修复组和关节镜修复组,每组各21例。切开修复组患者使用改良切开修复巨大肩袖撕裂,关节镜修复组患者使用关节镜下肩袖滑移技术修复巨大肩袖。记录并比较患者术前情况,包括患者的VAS评分、肩关节UCLA评分、肩关节Constant-Murley评分、肩袖受伤情况、受伤至手术的时间等。所有患者术后3个月和6个月门诊随访,记录并比较两组患者VAS评分、肩关节UCLA评分、肩关节Constant-Murley评分和末次随访患者满意度评分以评价两种手术疗效。结果两组患者术前各观察指标比较差异均无统计学意义(P>0.05)。术后3个月关节镜修复组VAS评分、肩关节UCLA评分和肩关节Constant-Murley评分分别是4.9±1.2分、29.1±4.5分和72.4±13.9分,而切开修复组上述指标分别为6.3±1.6分、21.7±3.9分和61.8±10.6分。关节镜修复组患者的疼痛VAS评分低于切开修复组,差异具有统计学意义(P<0.05);关节镜修复组患者的肩关节UCLA评分和肩关节Constant-Murley评分均高于切开修复组,差异具有统计学意义(P<0.05)。术后6个月,关节镜修复组VAS评分、肩关节UCLA评分和肩关节Constant-Murley评分分别是3.7±1.3分、32.6±4.7分和82.1±10.8分,而切开修复组上述指标分别为3.9±1.4分、32.8±4.5分和81.5±11.3分,差异均无统计学意义(P>0.05)。术后末次随访时,关节镜修复组患者的满意度评分(84.3±15.1分)显著高于切开修复组(72.9±12.3分),差异具有统计学意义(P<0.05)。结论关节镜下肩袖间隙滑移技术能够有效地修复巨大肩袖撕裂,比切开肩袖修复巨大肩袖撕裂术后康复得更快。

Application of rotator interval slide technique in arthroscopic repair of massive rotator cuff tears

Objective To evaluate the clinical efficacy of rotator interval slide technique in arthroscopic repair of massive rotator cuff tears.Methods From January 2015 to March 2019,42 patients with massive rotator cuff tears treated in Beijing Pinggu District Hospital were retrospectively selected.They were divided into two groups according to different operative method:the arthroscopic repair group(arthroscopic repair of massive rotator cuff tears by rotator interval slide technique,n=21)and open repair group(modified open repair of massive rotator cuff tears,n=21).Preoperative general condition of all patients including Visual Analogue Scale(VAS),University of California Los Angeles(UCLA)shoulder score,Constant-Murley shoulder scores,injury conditions of rotator cuff and interval time between injury and operation were recorded and compared.All the patients were followed up outpatiently at three and six months after operation,and VAS,UCLA,Constant-Murley scores and the patient satisfaction score at final followed-up of both groups were recorded and compared to evaluate the clinical efficacy of two operation methods.Results There were no statistically significant differences between the two groups in general conditions before operation(P>0.05).At three months postoperation,VAS,UCLA and Constant-Murley scores of the arthroscopic repair group were 4.9±1.2,29.1±4.5 and 72.4±13.9,while the scores of the open repair group were 6.3±1.6,21.7±3.9 and 61.8±10.6.VAS of the arthroscopic repair group was much lower than that of the open repair group and there was statistically significant difference between the two groups(P<0.05).UCLA and Constant-Murley scores of the arthroscopic repair group were much higher than those of the open repair group and there were statistically significant differences between the two groups(P<0.05).At six months postoperation,VAS,UCLA and Constant-Murley scores of the arthroscopic repair group were 3.7±1.3,32.6±4.7 and 82.1±10.8,while the scores of the open repair group were 3.9±1.4,32.8±4.5 and 81.5±11.3.There were no statistically significant differences between the two groups in VAS,UCLA and Constant-Murley scores(P>0.05).At final followed-up,the satisfaction score of arthroscopic repair group(84.3±15.1)was much higher than that of open repair group(72.9±12.3)and there was statistically significant difference between the two groups(P<0.05).Conclusion Rotator interval slide technique in arthroscopic repair of massive rotator cuff tears can effectively repair rotator cuff tears,and was helpful for patients to recovery faster than undergoing open repair of rotator cuff tears.