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肩峰下减压术后 8-11 年的长期患者满意度和功能结果。

Long-term patient satisfaction and functional outcome 8-11 years after subacromial decompression.

机构信息

Department of Physiotherapy, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2010 Mar;18(3):394-403. doi: 10.1007/s00167-009-0963-1. Epub 2009 Oct 23.

Abstract

The aim of this investigation was to evaluate the long-term outcome of arthroscopic subacromial decompression (ASD) in patients with primary impingement syndrome stage II and early stage III. Ninety-five patients (105 shoulders, 48 female), mean age 54 years (range 26-69), who had undergone surgery between 1996 and 1999, were included. Pain intensity during activity and at rest, patient satisfaction, active range of motion (ROM), muscular strength and shoulder function using the Constant score were evaluated. Fifty-three (50%) shoulders were pain-free (Visual Analogue Scale < or = 10 mm) during activity and 72 (68%) shoulders were pain-free at rest. Sixty-one (58%) patients stated that they were very satisfied and 27 (25%) were quite satisfied with regard to their current shoulder function. Shoulders were divided into Group 1: Pain-free patients (n = 53), Group 2: Patients with shoulder pain and no arthropathy (n = 41) and Group 3: Patients with shoulder pain and arthropathy (n = 11). The groups had average active ROM of 157 degrees, 135 degrees and 117 degrees, respectively, in abduction and 97 degrees, 79 degrees, and 68 degrees in external rotation. The average strength in elevation in the scapular plane was 7.4, 5.8 and 3.9 kg, respectively, whereas the mean value in external rotation was 8.4, 7.9 and 5.3 kg, respectively. The Constant score had a mean value of 87, 69 and 59 points in the three groups, respectively. Eleven shoulders have undergone re-operation, one after a new trauma. We conclude that ASD is a valuable procedure. Patients expressed a high degree of satisfaction with shoulder function 8-11 years after ASD.

摘要

本研究旨在评估关节镜下肩峰下减压术(ASD)治疗原发性撞击综合征Ⅱ期和早期Ⅲ期患者的长期疗效。纳入 1996 年至 1999 年间手术的 95 例(105 肩,48 例女性)患者,平均年龄 54 岁(26-69 岁)。评估内容包括活动时和休息时的疼痛强度、患者满意度、主动活动范围(ROM)、肌肉力量和使用 Constant 评分评估的肩部功能。53 肩(50%)活动时无痛(视觉模拟评分<或=10mm),72 肩(68%)休息时无痛。61 例(58%)患者对当前肩部功能非常满意,27 例(25%)满意。将肩部分为 3 组:无痛组(n=53)、有肩痛但无关节炎组(n=41)和有肩痛及关节炎组(n=11)。各组外展时的平均主动 ROM 分别为 157°、135°和 117°,外旋时分别为 97°、79°和 68°。肩胛平面上的平均提升力量分别为 7.4、5.8 和 3.9kg,外旋时分别为 8.4、7.9 和 5.3kg。三组 Constant 评分分别为 87、69 和 59 分。11 例肩接受了再次手术,其中 1 例因新创伤。我们的结论是,ASD 是一种有价值的手术。患者在 ASD 后 8-11 年对肩部功能的满意度很高。

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