| 关节镜自体半腱肌肌腱移植上关节囊重建术联合肱二头肌腱转位治疗不可修复性肩袖撕裂的早期疗效分析 |
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Received:December 11, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王锡豪 |
WANG Xi-hao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 杨智涛 |
YANG Zhi-tao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 梁钧文 |
LIANG Jun-wen |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 张柏荣 |
ZHANG Bai-rong |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 刘涛 |
LIU Tao |
兰州大学第二医院骨科, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China |
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| 姜金 |
JIANG Jin |
兰州大学第二医院骨科, 甘肃 兰州 730030
甘肃省骨关节疾病研究重点实验室, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
The Key Laboratory of Bone and Joint Diseases Research of Gansu Provincial, Lanzhou 730030, Gansu, China |
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| 韵向东 |
YUN Xiang-dong |
兰州大学第二医院骨科, 甘肃 兰州 730030
甘肃省骨关节疾病研究重点实验室, 甘肃 兰州 730030 |
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
The Key Laboratory of Bone and Joint Diseases Research of Gansu Provincial, Lanzhou 730030, Gansu, China |
xiangdongyun@126.com |
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| 期刊信息：《中国骨伤》2025年38卷，第3期，第238-244页 |
| DOI：10.12200/j.issn.1003-0034.20230950 |
| 基金项目:甘肃省卫生健康行业科研计划项目(编号:GSWSKY2023-23) |
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目的: 探讨关节镜自体半腱肌肌腱移植上关节囊重建术联合肱二头肌腱转位治疗不可修复性肩袖撕裂的早期临床疗效。
方法: 选取2019年10月至2021年3月行关节镜自体半腱肌肌腱移植上关节囊重建术联合肱二头肌腱转位治疗不可修复肩袖撕裂患者16例,其中男12例,女4例;年龄53~72(62.13±5.35)岁;左侧3例,右侧13例。所有患者术前有关节活动受限、静息痛和活动痛,且均有超过8个月保守治疗无效的病史。术前症状持续时间为45~144(85.25±32.08)个月。比较术前及术后2年肩关节疼痛视觉模拟评分(visual analogue scale,VAS)、美国加州大学洛杉矶分校(University of California Los Angeles,UCLA)评分、Constant-Murley评分及肩关节主动、被动活动度,并记录并发症情况。
结果: 16例术后均获得随访,时间21~32(24.25±3.57)个月。所有患者未发生切口感染、血管神经损伤及再撕裂等并发症。VAS、UCLA、Constant-Murley评分分别由术前的(5.75±1.18)、(11.88±3.38)、(33.38±9.34)分,改善至术后2年的(1.13±0.89)、(32.56±2.71)、(89.06±6.25)分,差异有统计学意义(P<0.05)。肩关节主动活动度前屈、外展、体侧外旋、体侧内旋分别由术前的(79.75±21.36)°、(62.06±10.49)°、(19.19±5.41)°、(3.04±0.21)°,改善至术后2年的(156.94±13.18)°、(116.19±12.59)°、(42.63±6.07)°、(8.16±0.64)°,差异有统计学意义(P>0.05);肩关节被动活动度前屈、外展、体侧外旋、体侧内旋分别由术前的(116.28±21.47)°、(107.12±9.67)°、(27.62±4.70)°、(4.21±0.41)°,改善至术后2年的(165.28±7.15)°、(153.34±4.69)°、(52.46±4.46)°、(9.68±0.68)°,差异有统计学意义(P<0.05)。
结论: 关节镜自体半腱肌肌腱移植上关节囊重建术联合肱二头肌腱转位治疗不可修复性肩袖撕裂患者可取得满意的早期临床疗效,是一种可靠且有效的手术方式。 |
| [关键词]:不可修复性肩袖撕裂 自体 移植 半腱肌 上关节囊重建 肱二头肌腱转位 关节镜 |
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| Early curative effect of upper capsular reconstruction combined with biceps tendon transposition for the treatment of unrepairable rotator cuff tear by arthroscopy |
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Abstract:
Objective To explore early curative effect of upper joint capsule reconstruction combined with biceps tendon transposition in treating irreparable rotator cuff tears.
Methods From October 2019 to March 2021,16 patients with irreparable rotator cuff tear were underwent arthroscopic autogenous semitendinosus tendon transplantation for upper articular capsule reconstruction combined with biceps tendon transposition,included 12 males and 4 females,aged from 53 to 72 years old with an average of (62.13±5.35) years old; 3 patients on the left side and 13 patients on the right side. All patients had preoperatively limited joint mobility,resting pain,and mobility pain,and had a history of failure to respond to conservative treatment for more than 8 months. The duration of preoperative symptoms ranged from 45 to 144 months with an average of (85.25±32.08) months. Visual analogue scale (VAS) of shoulder pain,University of California Los Angeles (UCLA) score,Constant-Murley score,active and passive motion of shoulder joint were compared before operation and 2 years after operation,complications were recorded.
Results All 16 patients were followed up for 21 to 32 months with an average of (24.25±3.57) months. There were no complications such as incision infection,vascular and nerve injury,retear occurred. VAS,UCLA and Constant-Murley scores were improved from (5.75±1.18),(11.88±3.38) and (33.38±9.34) before operation to (1.13±0.89),(32.56±2.71),(89.06±6.25) at 2 years after operation (P<0.05). Anterior flexion,abduction,lateral external rotation and lateral internal rotation of shoulder joint were improved from (79.75±21.36) °,(62.06±10.49) °,(19.19±5.41) °,(3.04±0.21) °,respectively to (156.94±13.18) °,(116.19±12.59) °,(42.63±6.07) °,(8.16±0.64) ° at 2 years after operation. Anterior flexion,abduction,lateral lateral rotation and lateral internal rotation of shoulder joint were improved from (116.28±21.47) °,(107.12±9.67) °,(27.62±4.70) °,(4.21±0.41) °,respectively to (165.28±7.15) °,(153.34±4.69) °,(52.46±4.46) °,(9.68±0.68) ° at 2 years after operation,and the difference was statistically significant (P<0.05).
Conclusion Arthroscopic autograft of semitendinosus tendon combined with transposition of biceps tendon could achieve satisfactory early clinical results in treating patients with irreparable rotator cuff tear,which is a reliable and effective surgical method. |
| KEYWORDS:Irreparable rotator cuff tear Autologous Transplantation Semitendinosus Upper joint capsule reconstruction Biceps tendon transposition Arthroscopy |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王锡豪,杨智涛,梁钧文,张柏荣,刘涛,姜金,韵向东.关节镜自体半腱肌肌腱移植上关节囊重建术联合肱二头肌腱转位治疗不可修复性肩袖撕裂的早期疗效分析[J].中国骨伤,2025,38(3):238~244 |
| 英文格式: | WANG Xi-hao,YANG Zhi-tao,LIANG Jun-wen,ZHANG Bai-rong,LIU Tao,JIANG Jin,YUN Xiang-dong.Early curative effect of upper capsular reconstruction combined with biceps tendon transposition for the treatment of unrepairable rotator cuff tear by arthroscopy[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(3):238~244 |
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