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关节镜下后盂唇修复在运动员中的应用:2 年随访结果分析。

Arthroscopic posterior labral repair in athletes: Outcome analysis at 2-year follow-up.

机构信息

The Orthopedic Institute of Wisconsin, Midwest Orthopedic Specialty Hospital, Franklin, 53132, USA.

出版信息

Arthroscopy. 2010 Sep;26(9):1162-71. doi: 10.1016/j.arthro.2010.01.006. Epub 2010 Jul 7.

Abstract

PURPOSE

The purpose of this outcome analysis was to evaluate the clinical presentation of isolated posterior labral tears resulting from athletic injury and to use multiple outcome measurements to evaluate postoperative results after arthroscopic repair with respect to satisfaction, function, and return to sport.

METHODS

Seventy-five consecutive patients injured during athletic activity were treated surgically during the 2-year period from 2005 to 2006 for labral pathologies. Twenty-eight patients were treated for isolated posterior labral tears. Of these, all underwent arthroscopic repair of their tears. The mechanism of injury was trauma to a previously asymptomatic shoulder during sports. The patients' mean age was 21 years, and they were evaluated with American Shoulder and Elbow Surgeons; University of California, Los Angeles; Rowe; and visual analog scale scores, as well as active motion and dynamometric strength testing. Scores and measurements were obtained preoperatively and postoperatively at 3, 6, and 12 months and yearly thereafter.

RESULTS

In our athletic population undergoing surgical management for labral pathology, 37% of patients (28 of 75) were found to have purely posterior labral lesions after an athletic injury. On intraoperative examination, an element of posterior laxity was seen in only 29% of patients with these tears. At 24 months, significant improvements were observed in the American Shoulder and Elbow Surgeons; University of California, Los Angeles; Rowe; and visual analog scale scores. Increases in forward flexion and external rotation strength were also noted. Return to sport was achieved in 26 of 28 patients (93%). A 93% patient satisfaction rate was observed for arthroscopic posterior labral repairs at more than 24 months.

CONCLUSIONS

Our patient-athletes presented with painful, dysfunctional shoulders that inhibited performance in their chosen sport. Arthroscopic evaluation and repair of these posterior labral lesions resulted in 26 of 28 patients (93%) returning to sport and 23 of 28 (82%) returning without any limitations.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

本研究旨在分析运动损伤导致的单纯性盂唇后体部撕裂的临床表现,并使用多种结局测量方法评估关节镜下修复后患者的满意度、功能和重返运动情况。

方法

2005 年至 2006 年的 2 年期间,我们对 75 例因盂唇病变接受手术治疗的运动损伤患者进行了连续研究。28 例患者接受了单纯性盂唇后体部撕裂的治疗。所有患者均接受了关节镜下撕裂修复。损伤机制为运动时无症状的肩部受到创伤。患者平均年龄 21 岁,我们采用美国肩肘外科医师协会评分、加利福尼亚大学洛杉矶分校评分、Rowe 评分及视觉模拟评分、主动活动度和动态力量测试对其进行评估。在术前、术后 3、6 和 12 个月以及此后每年进行评分和测量。

结果

在我们对接受盂唇病变手术治疗的运动人群进行的研究中,37%(28/75)的患者在运动损伤后发现存在单纯性盂唇后体部病变。术中检查时,这些撕裂患者中仅有 29%出现了后向松弛的表现。在 24 个月时,美国肩肘外科医师协会评分、加利福尼亚大学洛杉矶分校评分、Rowe 评分及视觉模拟评分均显著改善。前屈和外旋力量也有所增加。28 例患者中有 26 例(93%)重返运动。在超过 24 个月时,接受关节镜盂唇后体部修复的患者中,93%(26/28)对治疗效果满意。

结论

我们的运动员患者出现了肩部疼痛和功能障碍,从而影响了其运动表现。关节镜评估和修复这些盂唇后体部病变后,28 例患者中有 26 例(93%)重返运动,其中 23 例(82%)重返运动时没有任何限制。

证据等级

IV 级,治疗性病例系列研究。

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