Karas Spero G, Creighton R Alexander, DeMorat Gene J
Department of Orthopaedic Surgery, University of North Carolina Medical Center, Chapel Hill, North Carolina, USA.
Arthroscopy. 2004 Feb;20(2):179-84. doi: 10.1016/j.arthro.2003.11.004.
The purpose of this study was to objectively assess glenohumeral volume changes after arthroscopic suture plication, arthroscopic thermal capsulorrhaphy, and combined suture and thermal treatment.
Cadaveric study.
Five matched pairs of cadaver shoulders were treated with either thermal capsulorrhaphy (n = 5) or arthroscopic suture plication (n = 5). The shoulders treated with plication were then treated with thermal capsulorrhaphy to form a combined treatment group (plication and thermal). Preoperative and postoperative glenohumeral volume measurements were obtained, and the techniques were statistically compared with a 1-factor analysis of variance.
All 3 procedures produced marked decreases in glenohumeral capsular volume. Suture plication reduced intra-articular volume an average of 19.0%. Thermal capsulorrhaphy resulted in a mean capsular volume reduction of 33.4%. Combined treatment with suture plication and thermal capsulorrhaphy reduced glenohumeral volume an average of 41.0%. Both thermal capsulorrhaphy and the combined treatment produced significantly greater reduction in glenohumeral volume than plication alone (P <.0001). Although combined suture plication and thermal capsulorrhaphy resulted in greater reduction in capsular volume than thermal capsulorrhaphy alone, the differences were not statistically significant.
Our results indicate that arthroscopic suture plication and thermal capsulorrhaphy are both effective in reducing glenohumeral intra-articular volume. Thermal capsulorrhaphy alone or in combination with suture plication led to significantly greater reduction in capsular volume when compared with isolated suture plication.
本研究的目的是客观评估关节镜下缝合折叠术、关节镜下热囊缩术以及缝合与热疗联合治疗后盂肱关节容积的变化。
尸体研究。
五对匹配的尸体肩部标本分别接受热囊缩术（n = 5）或关节镜下缝合折叠术（n = 5）。对接受缝合折叠术治疗的肩部再进行热囊缩术，以形成联合治疗组（缝合折叠术与热疗）。术前和术后均测量盂肱关节容积，并采用单因素方差分析对这些技术进行统计学比较。
所有三种手术均使盂肱关节囊容积显著减小。缝合折叠术使关节内容积平均减少19.0%。热囊缩术使关节囊容积平均减少33.4%。缝合折叠术与热囊缩术联合治疗使盂肱关节容积平均减少41.0%。热囊缩术及联合治疗使盂肱关节容积的减小幅度均显著大于单纯缝合折叠术（P <.0001）。尽管缝合折叠术与热囊缩术联合治疗使关节囊容积的减小幅度大于单纯热囊缩术，但差异无统计学意义。
我们的结果表明，关节镜下缝合折叠术和热囊缩术在减少盂肱关节内容积方面均有效。与单纯缝合折叠术相比，单纯热囊缩术或缝合折叠术与热囊缩术联合应用导致关节囊容积显著更大幅度的减小。
