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关节镜下修复 II 型 SLAP 损伤的长期疗效:年龄和工人赔偿状况的结果。

Long-term outcome after arthroscopic repair of type II SLAP lesions: results according to age and workers' compensation status.

机构信息

The San Antonio Orthopaedic Group, San Antonio, Texas, USA.

出版信息

Arthroscopy. 2012 Apr;28(4):451-7. doi: 10.1016/j.arthro.2011.09.005. Epub 2012 Jan 21.

Abstract

PURPOSE

The purpose of this study was to determine the long-term functional outcome of anatomic arthroscopic repair of type II SLAP lesions with suture anchors.

METHODS

We examined all arthroscopic repairs of isolated type II SLAP lesions from January 2002 through December 2007. Fifty-five patients were available for long-term follow-up at a mean of 77 months. The mean patient age at the time of surgery was 39.7 years (range, 17 to 65 years); 23 patients were aged younger than 40 years, and 32 patients were aged 40 years or older. Fourteen cases involved Workers' Compensation claims.

RESULTS

Overall, functional outcome was improved from baseline compared with final follow-up for both American Shoulder and Elbow Surgeons scores (44.1 points v 86.2 points, P < .001) and University of California, Los Angeles scores (19.1 points v 31.2 points, P < .001). According to the University of California, Los Angeles grading system, 87% of cases had good or excellent results. Although the percentage of good and excellent results among patients aged 40 years or older (81%) was lower than that among patients aged younger than 40 years (97%), this difference did not reach statistical significance (P = .219). The percentage of good and excellent results among the non-Workers' Compensation cases (95%) was significantly higher than that in Workers' Compensation cases (65%) (P = .009). Overall, patient satisfaction was reported in 91% of cases, and return to normal sport or activity was reported in 82% of cases.

CONCLUSIONS

In 87% of cases, a good or excellent functional outcome can be anticipated after arthroscopic repair of type II SLAP lesions with the described techniques. Variables associated with a poor outcome include Workers' Compensation cases and possibly older age (≥40 years).

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

本研究旨在确定使用缝合锚进行解剖关节镜修复 II 型 SLAP 病变的长期功能结果。

方法

我们检查了 2002 年 1 月至 2007 年 12 月期间所有孤立性 II 型 SLAP 病变的关节镜修复。55 例患者在平均 77 个月时可进行长期随访。手术时患者的平均年龄为 39.7 岁(范围 17 至 65 岁);23 例患者年龄小于 40 岁,32 例患者年龄为 40 岁或以上。14 例涉及工人赔偿索赔。

结果

总体而言,与基线相比,美国肩肘外科医生评分(44.1 分对 86.2 分,P <.001)和加利福尼亚大学洛杉矶分校评分(19.1 分对 31.2 分,P <.001)的终末随访时功能均得到改善。根据加利福尼亚大学洛杉矶分校分级系统,87%的病例有良好或优秀的结果。尽管年龄在 40 岁或以上的患者(81%)中良好和优秀结果的百分比低于年龄小于 40 岁的患者(97%),但这一差异无统计学意义(P =.219)。非工人赔偿病例(95%)中良好和优秀结果的百分比明显高于工人赔偿病例(65%)(P =.009)。总体而言,91%的病例报告了患者满意度,82%的病例报告了恢复正常运动或活动。

结论

使用描述的技术进行 II 型 SLAP 病变的关节镜修复后,87%的病例可预期获得良好或优秀的功能结果。与不良结果相关的变量包括工人赔偿病例和可能的年龄较大(≥40 岁)。

证据水平

IV 级,治疗性病例系列。

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