Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
Arch Orthop Trauma Surg. 2013 Feb;133(2):227-35. doi: 10.1007/s00402-012-1657-6. Epub 2012 Nov 23.
Presumably, the technique of SLAP refixation has significant influence on outcome. This study analyzes and compares functional outcome and return to sports after arthroscopic suture anchor (SA) and arthroscopic transglenoidal suture (TS) repair of isolated SLAP-2 lesions.
Twenty-four competitive amateur athletes constituted the two treatment groups of this retrospective matched-pair analysis. In the SA group (n = 12), the mean age was 39.1 years (±12.0) and the mean follow-up period was 4.0 years (±0.6). In the TS group (n = 12), the mean age was 33.8 years (±12.0) and the mean follow-up period was 3.7 years (±0.9). The minimum follow-up period was 2.0 years. Primary outcome measures were the absolute constant-score (CS), the subjective shoulder value (SSV) as well as the ability to return to sports.
The mean CS in the SA group was 91.6 (±5.5) compared to 81.3 (±15.5) in the TS group (p = 0.04). The mean SSV after SA repair was 96.9 (±4.6) compared to 80.0 (±20.8) after TS repair (p = 0.01). Both scores showed significantly higher standard deviations within the TS group (p < 0.05). Twelve of eighteen patients (67 %) were able to return to their overhead sports without restrictions (5/9 in the SA group and 7/9 in the TS group; p > 0.05). Fourteen of twenty-four patients (58 %) achieved their preinjury sports levels (8/12 in the SA group and 6/12 in the TS group; p > 0.05).
Superior objective and subjective shoulder function was obtained following arthroscopic SA repair compared to arthroscopic TS repair of isolated SLAP-2 lesions. In addition, results of SA repair were more predictable. However, nearly half of the athletes did not achieve full return to sports regardless of the applied technique of refixation.
推测 SLAP 修复技术对结果有重大影响。本研究分析和比较了关节镜下缝合锚(SA)和关节镜下经冈上肌腱缝合(TS)修复孤立性 SLAP-2 病变后的功能结果和重返运动情况。
24 名竞技业余运动员构成了这项回顾性配对分析的两个治疗组。在 SA 组(n=12)中,平均年龄为 39.1 岁(±12.0),平均随访时间为 4.0 年(±0.6)。在 TS 组(n=12)中,平均年龄为 33.8 岁(±12.0),平均随访时间为 3.7 年(±0.9)。最小随访时间为 2.0 年。主要的结局测量指标是绝对常数评分(CS)、主观肩部值(SSV)以及重返运动的能力。
SA 组的平均 CS 为 91.6(±5.5),而 TS 组为 81.3(±15.5)(p=0.04)。SA 修复后的平均 SSV 为 96.9(±4.6),而 TS 修复后的平均 SSV 为 80.0(±20.8)(p=0.01)。两组的 TS 组标准差均显著较高(p<0.05)。18 名患者中的 12 名(67%)能够不受限制地重返上肢运动(SA 组 5/9,TS 组 7/9;p>0.05)。24 名患者中的 14 名(58%)恢复到受伤前的运动水平(SA 组 8/12,TS 组 6/12;p>0.05)。
与关节镜下 TS 修复孤立性 SLAP-2 病变相比,关节镜下 SA 修复可获得更好的客观和主观肩部功能。此外,SA 修复的结果更具可预测性。然而,无论应用哪种修复技术,近一半的运动员都无法完全恢复运动。