Köse Kamil Cağri, Tezen Engin, Cebesoy Oğuz, Karadeniz Engin, Guner Dervis, Adiyaman Sinan, Demirtas Mehmet
Department of Orthopaedics and Traumatology, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey.
Adv Ther. 2008 Mar;25(3):249-59. doi: 10.1007/s12325-008-0031-0.
Rotator cuff injury is one of the most frequently encountered problems of the shoulder in the daily practice of orthopaedic surgeons. This study compared all-arthroscopic cuff repair (ARCR) and mini-open rotator cuff repair (MORCR) methods in regard to clinical outcomes and costs.
Fifty patient charts and operative repairs were analysed (25 ARCR and 25 MORCR). Pre-and postoperative Constant-Murley and UCLA scores along with factors such as tear size, tear type, pre-operative physical therapy, motion and satisfaction levels were compared for the two procedures. Cost-benefit analysis was also performed for comparison between procedures. The duration of follow-up was 31.20 and 21.56 months for MORCR and ARCR groups, respectively.
Tear sizes (P=0.68), pre-and postoperative Constant-Murley and UCLA scores (P=0.254) and satisfaction levels were not significantly different between groups. However, the differences between pre-and postoperative Constant-Murley and UCLA scores were statistically significant within both groups (P<0.01). The MORCR group stayed 1 day longer in hospital than the ARCR group, which was statistically significant (P=0.036). The differences regarding mean pain scores, abductions, internal and external rotations in Constant-Murley scores and forward flexion scores in UCLA scores were not significant. The ARCR group cost more, leaving less profit.
Results suggest that ARCR yields similar clinical results but at a higher cost compared with MORCR.
在骨科医生的日常临床实践中，肩袖损伤是肩部最常见的问题之一。本研究比较了全关节镜下肩袖修复术（ARCR）和小切口开放肩袖修复术（MORCR）在临床疗效和成本方面的差异。
分析了50例患者的病历和手术修复情况（25例ARCR和25例MORCR）。比较了两种手术术前和术后的Constant-Murley评分和UCLA评分，以及撕裂大小、撕裂类型、术前物理治疗、活动度和满意度等因素。还进行了成本效益分析以比较两种手术。MORCR组和ARCR组的随访时间分别为31.20个月和21.56个月。
两组之间的撕裂大小（P = 0.68）、术前和术后的Constant-Murley评分及UCLA评分（P = 0.254）和满意度无显著差异。然而，两组内术前和术后的Constant-Murley评分及UCLA评分差异具有统计学意义（P < 0.01）。MORCR组的住院时间比ARCR组长1天，差异具有统计学意义（P = 0.036）。两组在平均疼痛评分、Constant-Murley评分中的外展、内旋和外旋以及UCLA评分中的前屈评分方面的差异不显著。ARCR组成本更高，利润更低。
结果表明，与MORCR相比，ARCR产生相似的临床结果，但成本更高。
