Paxinos Anastasios, Walton Judie, Rütten Sjoerd, Müller Michael, Murrell George A C
Sports Medicine and Shoulder Service and Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, Australia.
Arthroscopy. 2006 Jun;22(6):627-34. doi: 10.1016/j.arthro.2006.01.027.
This prospective study aimed to document the pain and functional outcomes, over time, of patients whose SLAP lesions had been repaired with biodegradable tacks.
Superior labral tears were identified in 24 patients from a cohort of 500 patients who had shoulder problems sufficiently disabling to warrant arthroscopic evaluation and management. These labral tears were arthroscopically repaired with 1 to 3 biodegradable tacks (mean, 1.6). Before surgery, all patients completed a questionnaire regarding their shoulder pain and function and were given a systematic clinical examination. To observe their postoperative outcomes over time, the same assessments were made at 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years after surgery.
After labral reattachment, decreases were noted in the patients' mean shoulder pain scores at rest (64% at 3 months), at night (76% at 3 months), and with activity (73% at 6 months). The most significant reductions in mean scores occurred between 6 and 12 weeks (P < .001). Patient-perceived weakness, instability, and stiffness scores also improved from week 6. The ranking of the patients' "overall problem" reduced from an average ranking of "severe" to "mild" by the third preoperative month (P < .001) and was still at this level by the time of their 2-year follow-up appointment. Activity levels for 22 of 24 patients returned to their preinjury levels by 6 months after surgery.
Arthroscopically delivered biodegradable tacks effectively managed superior labral tears and, on average, resulted in a near-complete improvement of pain and recovery of function by 3 months. These good outcomes did not improve further or deteriorate at the 2-year follow-up appointment.
Level IV, therapeutic case series.
本前瞻性研究旨在记录使用可生物降解钉修复SLAP损伤患者的疼痛及功能随时间的转归情况。
在500例因肩部问题严重而需接受关节镜评估与治疗的患者队列中，识别出24例存在上盂唇撕裂的患者。这些盂唇撕裂通过关节镜使用1至3枚可生物降解钉进行修复（平均1.6枚）。术前，所有患者均完成一份关于肩部疼痛及功能的问卷，并接受系统的临床检查。为观察术后随时间的转归情况，在术后2周、6周、3个月、6个月、1年及2年进行相同评估。
盂唇重新附着后，患者静息时平均肩部疼痛评分（3个月时降低64%）、夜间疼痛评分（3个月时降低76%）及活动时疼痛评分（6个月时降低73%）均出现下降。平均评分最显著的降低发生在6至12周之间（P < .001）。患者自我感知到的无力、不稳定及僵硬评分自第6周起也有所改善。患者“总体问题”的排名在术前第3个月时从平均“严重”级别降至“轻度”（P < .001），至2年随访时仍维持该水平。24例患者中有22例在术后6个月时活动水平恢复至受伤前水平。
关节镜下应用可生物降解钉能有效治疗上盂唇撕裂，平均而言，3个月时疼痛几乎完全改善，功能恢复。在2年随访时，这些良好的结果未进一步改善或恶化。
IV级，治疗性病例系列。
