Cohen David B, Coleman Struan, Drakos Mark C, Allen Answorth A, O'Brien Stephen J, Altchek David W, Warren Russell F
Sports Medicine and Shoulder Service, Hospital for Special Surgery Cornell Medical Center, New York, New York, USA.
Arthroscopy. 2006 Feb;22(2):136-42. doi: 10.1016/j.arthro.2005.11.002.
The objective was to clinically evaluate the treatment of type II Slap lesions repaired surgically using a bioabsorbable device.
Retrospective clinical follow-up study.
Forty-one patients with isolated type II SLAP lesions who were treated with arthroscopic fixation were identified. Patients were excluded for rotator cuff tears, instability, or subacromial decompression. Patients completed the L'Insalata and the American Society of Shoulder and Elbow Surgeons (ASES) questionnaires, and underwent a thorough shoulder examination at a minimum of 2 years postoperatively.
At a mean of 3.7 years follow-up, 33 of 41 patients returned for physical examination and 6 others returned the L'Insalata questionnaire. The mean L'Insalata and ASES scores were 86.7 and 86.8, respectively; 27 patients reported their satisfaction as good to excellent but only 14 of the 29 athletes returned to their preinjury level of athletics. The average ASES scores were statistically different in patients who had their rotator cuff pierced versus those who did not (P< .05). In addition, 13 of 16 patients who experienced night pain had a cuff piercing approach.
Despite high outcome scores, overall patient satisfaction was only 71%. In addition, up to 41% continued to experience some degree of night pain. Patients treated with a rotator cuff piercing had a significantly poorer outcome. Moreover, the patients who were athletes performed poorer on their outcomes evaluation than did their nonathletic counterparts. Whereas the outcome scores overall were high, this problem is still difficult to treat successfully. This may be because of the high demands of athletes. The data also suggest that placing portals through the rotator cuff may be associated with poorer surgical outcomes.
Level III.
本研究旨在对使用生物可吸收装置手术修复Ⅱ型SLAP损伤的治疗效果进行临床评估。
回顾性临床随访研究。
纳入41例接受关节镜下固定治疗的孤立性Ⅱ型SLAP损伤患者。排除存在肩袖撕裂、肩关节不稳或肩峰下减压的患者。患者完成L'Insalata问卷及美国肩肘外科医师学会（ASES）问卷，并在术后至少2年接受全面的肩部检查。
平均随访3.7年时，41例患者中有33例返回接受体格检查，另外6例返回了L'Insalata问卷。L'Insalata问卷和ASES问卷的平均得分分别为86.7分和86.8分；27例患者表示对治疗效果满意程度为良好至优秀，但29例运动员中只有14例恢复到受伤前的运动水平。肩袖被穿刺的患者与未被穿刺的患者的平均ASES得分在统计学上存在差异（P<0.05）。此外，16例夜间疼痛患者中有13例采用了肩袖穿刺入路。
尽管结果评分较高，但患者总体满意度仅为71%。此外，高达41%的患者仍持续存在一定程度的夜间疼痛。采用肩袖穿刺治疗的患者预后明显较差。此外，运动员患者在预后评估中的表现比非运动员患者差。尽管总体结果评分较高，但该问题仍难以成功治疗。这可能是由于运动员的要求较高。数据还表明，通过肩袖放置切口可能与较差的手术结果相关。
Ⅲ级。
