Ozbaydar Mehmet Uğur, Tonbul Murat, Yurdoğlu Cihangir, Yalaman Okan
Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Kliniği), Istanbul Okmeydani Training and Research Hospital, Istanbul, Turkey.
Acta Orthop Traumatol Turc. 2005;39(2):121-7.
We retrospectively evaluated the results of patients who underwent arthroscopic-assisted mini-open repair of rotator cuff tears.
Twenty-three patients (7 males, 16 females; mean age 56 years; range 41 to 75 years) underwent arthroscopic-assisted mini-open repair for nonretracted rotator cuff tears. The right shoulder was involved in 15 patients and the left in eight patients; 83% being on the dominant side. The range of motion was measured with a goniometer, and muscle strength by manual examination. The patients were assessed by physical examination, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the UCLA scale, and magnetic resonance imaging (MRI). The mean follow-up was 32 months (range 12 to 61 months).
All the patients had medium-sized ruptures. Biceps tenotomy was performed in three patients for tears affecting more than 50% of the biceps tendon. The mean preoperative active forward flexion increased from 99 degrees to 161 degrees , and active external rotation from 28 degrees to 50 degrees postoperatively (p<0.05); the strength of the supraspinatus and infraspinatus muscles increased significantly (p<0.05). The mean UCLA score was found as 31.6, showing an excellent result in nine patients (39.1%), good in 12 patients (52.2%), moderate in one (4.4%), and poor in one patient. The mean preoperative ASES score increased from 23.7 to 92.4 (p<0.05). The mean healing time was 1.7 months (range 1.5 to 12 months). Twenty-one patients (91.3%) were satisfied with the outcome. Of 16 patients with postoperative MRI scans, three (18.8%) exhibited recurrent ruptures.
In selective cases, the clinical and functional results are successful following arthroscopic-assisted mini-open repair for rotator cuff tears.
我们回顾性评估了接受关节镜辅助小切口修复肩袖撕裂患者的治疗结果。
23例患者(7例男性,16例女性;平均年龄56岁;范围41至75岁)接受关节镜辅助小切口修复非退缩性肩袖撕裂。15例患者右侧肩部受累,8例患者左侧肩部受累;83%为优势侧。使用量角器测量活动范围,通过手法检查评估肌肉力量。通过体格检查、美国肩肘外科医师协会标准化肩部评估表(ASES)、加州大学洛杉矶分校(UCLA)评分量表以及磁共振成像(MRI)对患者进行评估。平均随访时间为32个月(范围12至61个月)。
所有患者均为中型撕裂。3例患者因肱二头肌肌腱撕裂超过50%而进行了肱二头肌肌腱切断术。术前平均主动前屈从99度增加到术后161度,主动外旋从28度增加到50度(p<0.05);冈上肌和冈下肌力量显著增加(p<0.05)。UCLA平均评分为31.6,9例患者(39.1%)结果为优,12例患者(52.2%)为良,1例(4.4%)为中,1例患者为差。术前ASES平均评分从23.7增加到92.4(p<0.05)。平均愈合时间为1.7个月(范围1.5至12个月)。21例患者(91.3%)对结果满意。16例进行术后MRI扫描的患者中,3例(18.8%)出现复发性撕裂。
在选择性病例中,关节镜辅助小切口修复肩袖撕裂后的临床和功能结果是成功的。