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穿线套索固定法与转全层缝合修复冈上肌腱关节侧部分撕裂的疗效比较
Hits: 1952   Download times: 658   Received:July 09, 2021    
作者Author单位UnitE-Mail
陈孙裕 CHEN Sun-yu 福州市第二医院运动医学科, 福建 福州 350007 Department of Sports Medicine, the Second Hospital of Fuzhou, Fuzhou 350007, Fujian, China hunson2009@163.com 
肖展豪 XIAO Zhao-hao 福州市第二医院运动医学科, 福建 福州 350007 Department of Sports Medicine, the Second Hospital of Fuzhou, Fuzhou 350007, Fujian, China  
王建坤 WANG Jian-kun 福州市第二医院运动医学科, 福建 福州 350007 Department of Sports Medicine, the Second Hospital of Fuzhou, Fuzhou 350007, Fujian, China  
期刊信息:《中国骨伤》2022年35卷,第3期,第203-208页
DOI:10.12200/j.issn.1003-0034.2022.03.002
基金项目:福建省卫计委推广项目(编号:2014022)


目的: 比较关节镜下穿线套索固定法与转全层缝合修复冈上肌腱关节侧部分撕裂的临床疗效。

方法: 回顾性分析2015年7月至2018年11月,采用穿线套索固定法修复冈上肌腱关节侧部分撕裂21例(A组),年龄45~62(53.2±6.4)岁;男12例,女9例。采用转全层缝合修复冈上肌腱关节侧部分撕裂24例(B组),年龄40~64(55.7±5.2)岁;男14例,女10例。记录两组患者术前、末次随访时美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分,美国加州大学洛杉矶分校(University of California,Los Angeles,UCLA)肩关节评分,对两组患者临床数据进行比较分析,采用MRI观察术后肌腱愈合情况,评价手术疗效。

结果: 所有患者获得随访,时间20~27(23.7±3.1)个月,无并发症发生。穿线套索固定法组患者ASES评分和UCLA评分分别由术前的(50.6±6.4)、(15.6±2.7)分提高至术后的(87.3±5.2)、(31.6±2.4)分。转全层缝合组患者ASES评分和UCLA评分分别由术前的(52.3±5.6)、(16.8±2.4)分提高至术后的(90.1±4.8)、(32.1±2.8)分。组间术前及术后ASES评分和UCLA评分差异均无统计学意义。两组患者术后肩袖愈合情况差异也无统计学意义(χ2=2.374,P=0.128)。

结论: 采用关节镜下穿线法套索固定法和转全层缝合法修复冈上肌腱关节侧部分撕裂均可获得良好的临床疗效,穿线套索固定法修复是一项新的穿腱技术,更好地保留了未损伤的冈上肌腱。
[关键词]:关节镜  肩袖撕裂  修复外科手术  肩关节
 
Threading lasso fixation versus full-thickness conversion in repairing articular-sided partial-thickness supraspinatus tendon tears
Abstract:

Objective: To compare the effect of two different arthroscopic procedures,threading lasso fixation and full-thickness conversion,for repairing articular-sided partial-thickness supraspinatus tendon tear.

Methods: From July 2015 to November 2018,21 patients with articular-sided partial-thickness supraspinatus tendon tears underwent arthroscopic modified threading lasso fixation repair(group A). There were 12 males and 9 females in the group,with an average age of(53.2±6.4)years old. Twenty-four patients with articular-sided partial-thickness supraspinatus tendon tears received arthroscopic full-thickness conversion repair(group B). In this group,there were 14 males and 10 females,with an average age of (55.7±5.2) years old. The American Shoulder and Elbow Surgeons (ASES) score and University of California Los Angeles (UCLA) shoulder score were used to evaluate preoperative and postoperative clinical function. MRI was used to examine the healing status of the reconstructed rotator cuff.

Results: All patients were followed up,and the duration ranged from 20 to 27 months,with a mean of (23.7±3.1) months. In threading lasso fixation group,ASES score and UCLA score increased from 50.6±6.4 and 15.6±2.7 preoperatively to 87.3±5.2 and 31.6±2.4 postoperatively. In full-thickness conversion group,ASES score and UCLA score increased from 52.3±5.6 and 16.8±2.4 scores to 90.1±4.8 and 32.1±2.8. There were also no significant differences in ASES score and Constant score between the two groups before and after operation. There were no significant differences in rotator cuff healing between the two groups(χ2=2.374,P=0.128).

Conclusion: For the treatment of articular-sided partial-thickness supraspinatus tendon tears both arthroscopic repairs employing threading lasso fixation and full-thickness conversion could achieve satisfactory clinical results,and there are no significant differences in clinical outcomes between the two techniques. Arthroscopic repair with threading lasso fixation is a novel transtendinous procedure in which integrity of the tendon can be preserved.
KEYWORDS:Arthroscopes  Rotator cuff tears  Reconstructive surgical procedures  Shoulder joint
 
引用本文,请按以下格式著录参考文献:
中文格式:陈孙裕,肖展豪,王建坤.穿线套索固定法与转全层缝合修复冈上肌腱关节侧部分撕裂的疗效比较[J].中国骨伤,2022,35(3):203~208
英文格式:CHEN Sun-yu,XIAO Zhao-hao,WANG Jian-kun.Threading lasso fixation versus full-thickness conversion in repairing articular-sided partial-thickness supraspinatus tendon tears[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):203~208
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