Burns Joseph P, Snyder Stephen J
The Southern California Orthopedic Institute, Van Nuys, CA, USA.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1):90-6. doi: 10.1016/j.jse.2007.05.006.
Thirty-seven patients (41 shoulders) younger than 50 years of age (mean age, 43.7 years) underwent all-arthroscopic repairs of rotator cuff tears between 1994 and 2002. With a minimum 3-year follow-up (average 69 months, range 37-161 months), postoperative function was assessed by means of a UCLA scoring system, range of motion measurements, strength exam, and VAS pain score. Tears were categorized into 4 groups by type and size: partial undersurface tears, complete tears that were small (<1 cm), medium (1-3 cm), or large/massive (4-5 cm). All but 1 patient (97%) was subjectively satisfied and felt to be improved postoperatively. Average postoperative UCLA score improved significantly, and 95% of the shoulders achieved good or excellent postoperative results. Postoperative pain scores and strength evaluation also improved significantly. There was no significant loss of motion postoperatively and outcomes were independent of tear size and type. To date, there have been no revisions. These treatment results suggest that arthroscopic management in patients younger than 50 can achieve predictably good to excellent results regardless of tear size.
1994年至2002年间,37例(41个肩部)年龄小于50岁(平均年龄43.7岁)的患者接受了全关节镜下肩袖撕裂修补术。经过至少3年的随访(平均69个月,范围37 - 161个月),通过加州大学洛杉矶分校(UCLA)评分系统、活动范围测量、力量检查和视觉模拟评分(VAS)疼痛评分对术后功能进行评估。根据撕裂类型和大小将撕裂分为4组:部分下表面撕裂、小的(<1 cm)、中等的(1 - 3 cm)或大/巨大的(4 - 5 cm)完全撕裂。除1例患者外(97%),所有患者主观上都对术后情况感到满意,并觉得有所改善。术后UCLA平均评分显著提高,95%的肩部术后结果为良好或优秀。术后疼痛评分和力量评估也显著改善。术后活动度没有明显丧失,结果与撕裂大小和类型无关。迄今为止,没有进行翻修手术。这些治疗结果表明,50岁以下患者的关节镜治疗无论撕裂大小均可取得可预测的良好至优秀结果。