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经皮SLAP损伤修复技术是威尔明顿入路的一种有效替代方法。

Percutaneous SLAP lesion repair technique is an effective alternative to portal of Wilmington.

作者信息

Galano Gregory J, Ahmad Christopher S, Bigliani Louis, Levine William

机构信息

Department of Orthopedic Surgery, Columbia University, New York, New York, USA.

出版信息

Orthopedics. 2010 Nov 2;33(11):803. doi: 10.3928/01477447-20100924-15.

Abstract

Athletes with superior labral tear from anterior to posterior (SLAP) lesions place large demands on their rotator cuff and often have partial articular-sided rotator cuff tears as part of an internal impingement process. A percutaneous technique that facilitates SLAP repair may decrease the rotator cuff morbidity associated with establishment of the standard Wilmington portal. The current study reports the clinical outcome of patients with SLAP lesions treated with a percutaneous repair technique. Twenty-two patients with SLAP lesions underwent percutaneous repair. Mean patient age was 26.9 years. Standard posterior viewing and anterior working portals were used. Anchor placement and suture passing were performed with a 3-mm percutaneous and transtendinous approach to the superior labrum. Knot tying was performed via the standard anterior working portal. Clinical outcomes were assessed with validated shoulder evaluation instruments. Mean follow-up was 31.1 months (±6.6 months). Improvement of shoulder evaluation scores from pre- to postoperative were as follows: American Shoulder and Elbow Surgeons score improved from 49.5 to 83.6, visual analog scale improved from 5.4 to 1.5, and Simple Shoulder Score improved from 6.4 to 11.0. All were significant improvements (P<.05). There was no significant difference in functional scores between Type II lesions versus combined lesions, or between patients with or without a concurrent low-grade rotator cuff tear. Ninety percent of athletes were able to return to sport at pre-injury level of function. Percutaneously-assisted arthroscopic SLAP lesion repair may minimize surgical morbidity to the rotator cuff and provides excellent results.

摘要

患有从前往后的上盂唇前上后向(SLAP)损伤的运动员对其肩袖的要求很高,并且作为内部撞击过程的一部分,常常伴有部分关节侧肩袖撕裂。一种有助于SLAP修复的经皮技术可能会降低与建立标准威尔明顿入路相关的肩袖发病率。本研究报告了采用经皮修复技术治疗SLAP损伤患者的临床结果。22例SLAP损伤患者接受了经皮修复。患者平均年龄为26.9岁。使用标准的后侧观察入路和前侧操作入路。采用3毫米经皮和经肌腱入路对上盂唇进行锚钉置入和缝线穿过。通过标准的前侧操作入路进行打结。使用经过验证的肩部评估工具评估临床结果。平均随访时间为31.1个月(±6.6个月)。术前至术后肩部评估评分的改善情况如下:美国肩肘外科医师协会评分从49.5提高到83.6,视觉模拟评分从5.4提高到1.5,简单肩部评分从6.4提高到11.0。所有均为显著改善(P<0.05)。II型损伤与复合型损伤之间,以及伴有或不伴有同时存在的低度肩袖撕裂的患者之间,功能评分无显著差异。90%的运动员能够恢复到受伤前的功能水平。经皮辅助关节镜下SLAP损伤修复可将肩袖的手术发病率降至最低,并提供优异的结果。

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