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经单一前侧入路采用垂直缝线与水平缝线修复孤立型 II 型 SLAP 损伤:一项随机对照试验。

Vertical versus horizontal suture configuration for the repair of isolated type II SLAP lesion through a single anterior portal: a randomized controlled trial.

机构信息

Clinica Universitaria de Navarra, Madrid, Spain.

出版信息

Arthroscopy. 2011 Dec;27(12):1605-13. doi: 10.1016/j.arthro.2011.07.009. Epub 2011 Oct 19.

Abstract

PURPOSE

To compare the clinical and functional outcomes of the repair of an isolated type II SLAP lesion by 2 different configuration techniques (vertical v horizontal suture) through a single anterior portal.

METHODS

We designed a prospective, double-blinded, randomized clinical trial. A junior orthopaedic surgeon, who made the initial diagnosis, used a 10-point visual analog scale for pain and subjective instability and the American Shoulder and Elbow Surgeons (ASES) scoring system and evaluated the range of motion. After a diagnostic arthroscopy that ascertained the presence of an isolated type II SLAP lesion, patients were randomized to receive either vertical suture configuration (group 1) or horizontal suture configuration (group 2), both through a single anterior portal. Thirty-two patients were included in the study. The mean follow-up time was 37 months.

RESULTS

The mean postoperative ASES score was 91.9 in group 1 versus 95.8 in group 2 (P > .05). The differences observed from preoperative ASES score for both groups to postoperative ASES score were statistically significant. The differences observed in preoperative range of motion from the contralateral healthy shoulder and the affected shoulder in both groups were all clinically and statistically significant. Comparing the overall range of motion of the affected limb postoperatively with the range of motion of the contralateral healthy shoulder and between both groups, we found no statistically significant differences in forward flexion (P = .067), external rotation (P = .101), or internal rotation (P = .343).

CONCLUSIONS

The results of this study suggest that the repair of an isolated type II SLAP lesion through a single anterior portal is clinically and functionally beneficial to patients regardless of the suture configuration performed (vertical or horizontal suture) because no differences were observed between these configurations after repair of an isolated type II SLAP lesion.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

摘要

目的

比较通过单一前侧入路采用 2 种不同缝线构型(垂直缝线与水平缝线)修复单纯 II 型 SLAP 损伤的临床和功能结果。

方法

我们设计了一项前瞻性、双盲、随机临床试验。一位初级骨科医生做出初始诊断,使用 10 分视觉模拟评分法(VAS)评估疼痛和主观不稳定性,使用美国肩肘外科医师协会(ASES)评分系统评估活动度。在初次关节镜检查确定存在单纯 II 型 SLAP 损伤后,患者随机分为接受垂直缝线构型(第 1 组)或水平缝线构型(第 2 组)修复,均通过单一前侧入路。共有 32 例患者纳入研究。平均随访时间为 37 个月。

结果

第 1 组术后 ASES 评分为 91.9,第 2 组为 95.8(P>.05)。两组术前 ASES 评分与术后 ASES 评分的差异均有统计学意义。两组术前与健侧肩关节相比,患侧肩关节活动度的差异均具有临床和统计学意义。比较术后患侧肢体的整体活动度与健侧肩关节之间以及两组之间的差异,我们发现,在肩关节前屈(P =.067)、外旋(P =.101)或内旋(P =.343)方面,差异均无统计学意义。

结论

本研究结果表明,通过单一前侧入路修复单纯 II 型 SLAP 损伤对患者具有临床和功能益处,无论采用哪种缝线构型(垂直缝线或水平缝线)均可,因为在修复单纯 II 型 SLAP 损伤后,这两种构型之间没有观察到差异。

证据等级

I 级,随机对照试验。

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