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[1]王鵬,危立軍.關(guān)節(jié)鏡下全縫線錨釘固定治療肩袖損傷的臨床研究[J].中醫(yī)正骨,2023,35(10):26-30,36.
　WANG Peng,WEI Lijun.A clinical study of arthroscopic all-suture anchor fixation for treatment of rotator cuff injuries[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(10):26-30,36.
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關(guān)節(jié)鏡下全縫線錨釘固定治療肩袖損傷的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年10期
頁碼:
26-30,36
欄目:
臨床研究
出版日期:
2023-10-20

文章信息/Info

Title:
A clinical study of arthroscopic all-suture anchor fixation for treatment of rotator cuff injuries
作者:
王鵬; 危立軍
普陀普舟醫(yī)院,浙江 舟山 316199
Author(s):
WANG Peng; WEI Lijun
Putuo Puzhou Hospital,Zhoushan 316199,Zhejiang,China
關(guān)鍵詞:
肩袖損傷;  關(guān)節(jié)鏡檢查;  縫合錨;  臨床試驗(yàn)
Keywords:
rotator cuff injuries;  arthroscopy;  suture anchors;  clinical trial
摘要:
目的:觀察關(guān)節(jié)鏡下全縫線錨釘固定治療肩袖損傷的臨床療效及安全性。方法:回顧性分析96例肩袖損傷患者的病例資料,均在關(guān)節(jié)鏡下手術(shù),其中采用全縫線錨釘固定治療50例(全縫線錨釘組)、采用傳統(tǒng)錨釘固定治療46例(傳統(tǒng)錨釘組)。比較2組患者的肩部疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分、美國加州大學(xué)(the University of California at Los Angeles,UCLA)肩關(guān)節(jié)評(píng)分、美國肩肘外科協(xié)會(huì)(American shoulder and elbow surgeons,ASES)評(píng)分、Constant-Murley肩關(guān)節(jié)評(píng)分、肩關(guān)節(jié)活動(dòng)度(外旋、外展、上舉)及并發(fā)癥發(fā)生率。結(jié)果:術(shù)前2組患者的肩部疼痛VAS評(píng)分比較,組間差異無統(tǒng)計(jì)學(xué)意義; 術(shù)后1年,2組患者的肩部疼痛VAS評(píng)分均降低(t=32.920,P=0.000; t=13.325,P=0.000),且全縫線錨釘組的肩部疼痛VAS評(píng)分低于傳統(tǒng)錨釘組[(1.58±0.61)分,(3.35±0.48)分,t=15.683,P=0.000]。術(shù)前2組患者的UCLA肩關(guān)節(jié)評(píng)分、ASES評(píng)分、Constant-Murley肩關(guān)節(jié)評(píng)分比較,組間差異均無統(tǒng)計(jì)學(xué)意義; 術(shù)后1年,2組患者的UCLA肩關(guān)節(jié)評(píng)分、ASES評(píng)分、Constant-Murley肩關(guān)節(jié)評(píng)分均增加,但2組間的差異均無統(tǒng)計(jì)學(xué)意義。術(shù)前2組患者的肩關(guān)節(jié)外旋、外展、上舉活動(dòng)度比較,組間差異均無統(tǒng)計(jì)學(xué)意義; 術(shù)后1年,2組患者的肩關(guān)節(jié)外旋、外展、上舉活動(dòng)度均增加,但2組間的差異均無統(tǒng)計(jì)學(xué)意義。術(shù)后至末次隨訪時(shí)(術(shù)后1年),全縫線錨釘組出現(xiàn)肩關(guān)節(jié)僵硬1例、錨釘脫出1例、骨髓水腫2例,傳統(tǒng)錨釘組出現(xiàn)肩關(guān)節(jié)僵硬9例、肩袖再次撕裂6例、錨釘脫出10例、骨髓水腫11例,全縫線錨釘組的并發(fā)癥發(fā)生率低于傳統(tǒng)錨釘組(χ2=48.661,P=0.000)。結(jié)論:關(guān)節(jié)鏡下全縫線錨釘固定與傳統(tǒng)錨釘固定治療肩袖損傷的臨床療效相當(dāng),但前者能更好地緩解肩部疼痛、減少并發(fā)癥發(fā)生。
Abstract:
Objective:To observe the clinical outcomes and safety of arthroscopic all-suture anchor(ASA)fixation for treatment of rotator cuff injuries.Methods:The clinical data of 96 patients with rotator cuff injuries were analyzed retrospectively.Fifty patients were treated with the ASA fixation(ASA group),and 46 ones with conventional anchor(CA)fixation(CA group).The procedures were all conducted under arthroscope.The shoulder pain visual analogue scale(VAS)score,the University of California at Los Angeles(UCLA)shoulder score,American shoulder and elbow surgeons(ASES)score,Constant-Murley shoulder score,shoulder range of motions(ROMs)including outward rotation,abduction,upward lift and postoperative complication incidence were compared between the 2 groups.Results:The difference was not statistically significant in the shoulder pain VAS score between the 2 groups before the procedure; however,at 12 months after the procedure,the shoulder pain VAS score decreased in the 2 groups(t=32.920,P=0.000; t=13.325,P=0.000),and it was lower in ASA group compared to CA group(1.58±0.61 vs 3.35±0.48 points,t=15.683,P=0.000).The differences were not statistically significant in UCLA shoulder score,ASES score and Constant-Murley shoulder score between the 2 groups before the procedure; however,at 12 months after the procedure,the UCLA shoulder score,ASES score and Constant-Murley shoulder score increased in the 2 groups,while the differences were not statistically significant between the 2 groups.The differences were not statistically significant in shoulder ROMs,including outward rotation,abduction and upward lift,between the 2 groups before the procedure; however,at 12 months after the procedure,the shoulder ROMs,including outward rotation,abduction and upward lift,increased in the 2 groups,while the differences were not statistically significant between the 2 groups.From the post-procedure to the last follow-up(at 12 months after the procedure),the shoulder stiffness(1 case),anchor protrusion(1 case)and bone marrow edema(2 cases)were found in ASA group; while the shoulder stiffness(9 cases),rotator cuff re-tear(6 cases),anchor protrusion(10 cases)and bone marrow edema(11 cases)were found in CA group.The incidence rate of postoperative complications was lower in ASA group compared to CA group(χ2=48.661,P=0.000).Conclusion:Arthroscopic ASA fixation is similar to arthroscopic CA fixation in clinical outcomes in treatment of rotator cuff injuries,while the former can better relieve shoulder pain and reduce complications compared to the latter.

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