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45 岁以上患者的 II 型前上盂唇前后(SLAP)病变的关节镜修复:一项前瞻性研究。

Arthroscopic repair of type II superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years: a prospective study.

机构信息

Department of Orthopaedics and Traumatology, Gazi University Hospital, Ankara, Turkey.

出版信息

Arch Orthop Trauma Surg. 2011 Aug;131(8):1107-13. doi: 10.1007/s00402-011-1348-8. Epub 2011 Jun 26.

DOI:10.1007/s00402-011-1348-8
PMID:21706304
Abstract

BACKGROUND

Superior labrum anterior posterior (SLAP) lesions are a well-defined cause of shoulder pain and disability and may occur in conjunction with rotator cuff tears. This study was designed to prospectively evaluate the minimum 2 year results of arthroscopic repair of type II SLAP lesions in patients over the age of 45 years with and without rotator cuff tears.

PATIENTS AND METHODS

Thirty-five patients with symptomatic type II SLAP lesions were enrolled in the study. All patients underwent arthroscopic SLAP repair and simultaneous repairs were carried out in 17 of these patients who had concomitant full-thickness rotator cuff tears. Patients were grouped into two with regard to the presence of rotator cuff tears. The outcome was assessed by University of California at Los Angeles (UCLA) score and clinical examination (forward flexion/internal rotation/external rotation).

RESULTS

At an average follow-up of 2.5 years, both groups displayed significant improvements in UCLA score (31.2 vs. 11.8; p < 0.01) and range of motion. Compared with the group that had SLAP and concomitant rotator cuff tears, patients in isolated SLAP group had significantly better scores in function (9.4 vs. 8.6; p = 0.045) and patient satisfaction (4.9 vs. 4.5; p = 0.039). No significant difference was found between two groups with respect to range of motion.

CONCLUSIONS

The arthroscopic repair of symptomatic type II SLAP lesions yields favorable outcomes in patients over 45 years of age and the presence of accompanying rotator cuff tears has a negative effect on the results.

摘要

背景

肩盂上唇前后损伤(SLAP)是明确的导致肩部疼痛和功能障碍的原因,可能与肩袖撕裂同时发生。本研究旨在前瞻性评估 45 岁以上患者 SLAP Ⅱ型病变的关节镜修复的至少 2 年结果,包括伴有和不伴有肩袖撕裂的患者。

患者和方法

35 例有症状的 SLAP Ⅱ型病变患者纳入本研究。所有患者均接受关节镜 SLAP 修复术,其中 17 例同时伴有全层肩袖撕裂的患者进行了同时修复。根据是否存在肩袖撕裂,将患者分为两组。通过加州大学洛杉矶分校(UCLA)评分和临床检查(前屈/内旋/外旋)评估结果。

结果

平均随访 2.5 年后,两组 UCLA 评分(31.2 比 11.8;p < 0.01)和活动范围均有显著改善。与 SLAP 伴发肩袖撕裂的组相比,孤立性 SLAP 组在功能(9.4 比 8.6;p = 0.045)和患者满意度(4.9 比 4.5;p = 0.039)方面的评分明显更好。两组在活动范围方面无显著差异。

结论

关节镜治疗 45 岁以上患者的症状性 SLAP Ⅱ型病变可获得良好的结果,同时伴有肩袖撕裂会对结果产生负面影响。

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