| 反肩置换治疗不可修复肩袖损伤18例 |
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Received:December 11, 2024
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王亮 |
WANG Liang |
宁波大学附属第一医院关节外科及运动医学科, 浙江 宁波 315000 |
Department of Joint Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
wangliang1983123@163.com |
| 叶如卿 |
YE Ru-qing |
宁波大学附属第一医院关节外科及运动医学科, 浙江 宁波 315000 |
Department of Joint Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 王猛 |
WANG Meng |
宁波大学附属第一医院关节外科及运动医学科, 浙江 宁波 315000 |
Department of Joint Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 张敏健 |
ZHANG Min-jian |
宁波大学附属第一医院关节外科及运动医学科, 浙江 宁波 315000 |
Department of Joint Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 唐旭 |
TANG Xu |
宁波大学附属第一医院关节外科及运动医学科, 浙江 宁波 315000 |
Department of Joint Surgery, the First Affiliated Hospital of Ningbo University, Ningbo 315000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2025年38卷，第3期，第258-264页 |
| DOI：10.12200/j.issn.1003-0034.20240581 |
| 基金项目:浙江省医药卫生科技计划项目(编号:2022KY1143;2024KY1539);宁波市卫生健康青年技术骨干人才培养专项项目[编号:甬卫发(2021)106号] |
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目的: 探讨反肩置换在巨大不可修复肩袖撕裂合并盂肱关节炎治疗中的临床疗效。
方法: 回顾性分析2020年4月至2022年4月收治的18例(18肩)合并巨大不可修复肩袖撕裂的盂肱关节炎患者,男10例,女8例;年龄60~78岁;左侧7例,右侧11例;病程6~21个月;Goutallier分级,3级7例,4级11例;Hamada分级,4b级8例,5级10例。比较末次随访肩关节活动度、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 at Los Angeles,UCLA)肩关节评分及Constant-Murley肩关节功能评分及并发症情况。
结果: 18例患者获得随访,时间24~48个月。末次随访,肩关节前屈120°~145°,外展100°~130°,旋45°~60°;VAS为1~3分;Constant-Murley评分为80~95分;UCLA评分为27~35分,其中优6例,良11例,一般1例。1例术后3个月发生肩关节脱位,手法复位后再未发生脱位;1例术后1周切口表层感染,予抗感染及清洁换药后切口愈合;其余患者未发生脱位、感染、假体松动及周围骨折等并发症。
结论: 反肩置换术治疗巨大不可修复肩袖损伤合并盂肱关节炎疾病,临床效果良好,可明显改善肩关节功能,提高生活质量,但尚需加强术后脱位及感染等并发症预防及治疗。 |
| [关键词]:关节成形术 反肩置换 巨大肩袖损伤 关节炎 |
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| Reverse shoulder replacement for the treatment of 18 patients with unrepairable rotator cuff injury |
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Abstract:
Objective To explore clinical effect of reverse shoulder replacement in treating giant irreparable rotator cuff tear complicated with glenohumeral arthritis.
Methods A retrospective analysis was performed on 18 patients (18 shoulders) with glenohumeral arthritis combined with large irreparable rotator cuff tear admitted from April 2020 to April 2022,including 10 males and 8 females,aged from 60 to 78 years old;7 patients on the left side,11 patients on the right side;the course of disease ranged from 6 to 21 months;7 patients with grade 3 and 11 patients with grade 4 according to Goutallier grading;8 patients with grade 4b and 10 patients with grade 5 according to Hamada grading. Shoulder joint motion,visual analogue scale (VAS),University of California at Los Angeles (UCLA) score and Constant-Murley shoulder joint function score and complications were compared at the latest follow-up.
Results Eighteen patients were followed up for 24 to 48 months. At the latest follow-up,shoulder joint flexion ranged from 120° to 145°,abduction ranged from 100° to 130°,and rotation ranged from 45° to 60°. VAS ranged from 1 to 3;Constant-Murley score ranged from 80 to 95;and UCLA scores ranged from 27 to 35,and 6 patients obtained excellent result,11 good and 1 average. Dislocation of shoulder joint occurred in 1 patient at 3 months after operation,but no dislocation occurred after manual reduction. The incision surface infection occurred in 1 patient at 1 week after operation,and the incision healed after anti-infection and cleaning. The other patients did not have complications such as dislocation,infection,prosthesis loosening and peripheral fracture.
Conclusion Reverse shoulder replacement for the treatment of huge irreparable rotator cuff injury combined with glenohumeral arthritis disease,the clinical effect is good,could significantly improve shoulder joint function and improve quality of life,but still need to strengthen the prevention and treatment of postoperative complications such as dislocation and infection. |
| KEYWORDS:Arthroplasty Reverse total shoulder arthroplasty Massive rotator cuff damage Arthritis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王亮,叶如卿,王猛,张敏健,唐旭.反肩置换治疗不可修复肩袖损伤18例[J].中国骨伤,2025,38(3):258~264 |
| 英文格式: | WANG Liang,YE Ru-qing,WANG Meng,ZHANG Min-jian,TANG Xu.Reverse shoulder replacement for the treatment of 18 patients with unrepairable rotator cuff injury[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(3):258~264 |
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