Norlin Rolf, Adolfsson Lars
Department of Orthopaedics, University Hospital, Linköping, Sweden.
J Shoulder Elbow Surg. 2008 Jan-Feb;17(1 Suppl):12S-16S. doi: 10.1016/j.jse.2007.06.020.
A consecutive series of 181 patients with clinical signs of subacromial impingement underwent arthroscopic subacromial decompression (ASD). All patients had the same surgical procedure, and all pathological findings at the arthroscopy were recorded. Ten to 13 years (mean, 11.2) after the procedure, 162 patients (91%) were available for follow-up consisting of clinical examination and the Constant-Murley and DASH scores. The overall mean value of the age correlated Constant score was 77 points. Men had significantly better Constant score than women. The state of the rotator cuff at the index procedure was found to affect the outcome significantly. Patients with isolated full-thickness supraspinatus tears had the best results, followed by those with partial tears, intact cuffs, or large tears involving more than 1 tendon. ASD in the treatment of subacromial impingement yields good long-term results. Small full-thickness supraspinatus tears had the best results, indicating that the ASD might prevent further cuff deterioration and that repair of these lesions may be unnecessary.
连续181例有肩峰下撞击临床体征的患者接受了关节镜下肩峰下减压术(ASD)。所有患者均接受相同的手术操作,并记录关节镜检查时的所有病理发现。术后10至13年(平均11.2年),162例患者(91%)接受了随访,包括临床检查以及Constant-Murley和DASH评分。年龄相关Constant评分的总体平均值为77分。男性的Constant评分显著高于女性。发现初次手术时肩袖的状态对结果有显著影响。孤立性全层冈上肌撕裂的患者效果最佳,其次是部分撕裂、肩袖完整或涉及多条肌腱的大撕裂患者。ASD治疗肩峰下撞击可产生良好的长期效果。小的全层冈上肌撕裂效果最佳,表明ASD可能会防止肩袖进一步恶化,且这些病变可能无需修复。