Department of Orthopedic Surgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.
Arthroscopy. 2013 Aug;29(8):1283-91. doi: 10.1016/j.arthro.2013.05.024.
The purpose of this study is to describe a 1-stage treatment with concomitant arthroscopic capsular release and rotator cuff repair and present clinical outcomes with a minimum follow-up of 2 years.
Arthroscopic rotator cuff repair was performed in 211 consecutive patients. Forty-three patients had severe concomitant shoulder stiffness at the time of the repair. In the stiffness group, 1-stage arthroscopic capsular release and rotator cuff repair were performed. Preoperative mean passive forward flexion was 124°, whereas external rotation at the side was 309°. All patients were evaluated at a minimum 2-year follow-up, which included a visual analog scale score for pain, tests of muscle power and range of motion, the Constant score, and the modified American Shoulder and Elbow Surgeons shoulder evaluation form and modified University of California, Los Angeles scores.
The mean visual analog scale score during motion at the last follow-up was 1.5 in the stiffness group and 1.3 in the non-stiffness group. In the stiffness group, forward flexion was 175° whereas external rotation at the side was 60° postoperatively; shoulder motion improved (P < .001) and was comparable with that of the contralateral side. Other functional outcome instruments showed no statistical difference between the 2 groups.
In this study, 1-stage treatment of patients with rotator cuff tears and shoulder stiffness was performed by arthroscopic capsular release and cuff repair, and overall satisfactory results were achieved in selected patients. The results of the stiffness group in this study were statistically the same as those in the non-stiffness group.
Level III, retrospective comparative study.
本研究旨在描述一期关节镜下囊松解和肩袖修复治疗，并报告至少随访 2 年的临床结果。
对 211 例连续的肩袖撕裂患者进行了关节镜下肩袖修复。43 例患者在修复时伴有严重的合并性肩关节僵硬。在僵硬组中，进行了一期关节镜下囊松解和肩袖修复。术前平均被动前屈为 124°，而侧方外旋为 309°。所有患者均在至少 2 年的随访中进行评估，包括疼痛的视觉模拟评分、肌肉力量和活动范围测试、Constant 评分、改良美国肩肘外科医师评分和改良加利福尼亚大学洛杉矶评分。
僵硬组在末次随访时活动时的平均视觉模拟评分为 1.5，非僵硬组为 1.3。在僵硬组中，术后前屈为 175°，而侧方外旋为 60°；肩部运动得到改善（P<0.001），与对侧相似。其他功能结果指标在两组之间无统计学差异。
在这项研究中，通过关节镜下囊松解和肩袖修复对肩袖撕裂伴肩关节僵硬的患者进行了一期治疗，在选择的患者中取得了总体满意的结果。本研究中僵硬组的结果在统计学上与非僵硬组相同。
III 级，回顾性比较研究。
