Konradsen Lars Aage Glud, Jensen Claus Hjorth
Birkehaven 26, 3400 Hillerød, Denmark.
Dan Med J. 2015 Mar;62(3).
The aim of this study was to evaluate the outcome two years after arthroscopic subacromial decompression using the Western Ontario Rotator-Cuff (WORC) index and a diagram-based questionnaire to self-assess active shoulder range of motion (ROM).
Outcomes in 80 patients with impingement of the shoulder undergoing arthroscopic subacromial decompression were prospectively assessed preoperatively, at three months and at two years post-operatively using the WORC index. All patients had received non-operative treatment for at least six months before undergoing surgery. Active range of motion was measured preoperatively by the examining physician and at two years by the patient him-/herself using a diagram-based questionnaire to self-assess active shoulder ROM. A total of 75 patients (94%), of whom 31 were women, completed the study. The median age was 56 years. In all, 31 patients had additional resection of the acromioclavicular joint.
WORC scores improved significantly from preoperatively (median: 1,392) to three months (median: 204) and two years post-operatively (median: 243) (p < 0.001). A clinically significant decrease in the WORC index was observed in 83% of patients, but only 45% reported near normal or normal WORC scores, and 56% presented with a reduced active ROM at two years.
Arthroscopic subacromial decompression -appears effective in alleviating symptoms in patients with subacromial impingement who are resistant to conservative treatment, but can only be expected to restore normal shoulder function as measured by the WORC in less than 50% of the cases.
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本研究旨在使用西安大略肩袖(WORC)指数和基于图表的问卷来自我评估主动肩关节活动范围(ROM),以评估关节镜下肩峰下减压术后两年的疗效。
对80例因肩部撞击症接受关节镜下肩峰下减压的患者,在术前、术后三个月和两年时使用WORC指数进行前瞻性评估。所有患者在手术前均接受了至少六个月的非手术治疗。术前由检查医师测量主动活动范围,术后两年由患者本人使用基于图表的问卷来自我评估主动肩关节ROM。共有75例患者(94%)完成了研究,其中31例为女性,中位年龄为56岁。共有31例患者额外切除了肩锁关节。
WORC评分从术前(中位数:1392)显著提高到术后三个月(中位数:204)和两年(中位数:243)(p < 0.001)。83%的患者WORC指数出现了临床上显著的下降,但只有45%的患者报告WORC评分接近正常或正常,56%的患者在两年时主动ROM降低。
关节镜下肩峰下减压术似乎对保守治疗无效的肩峰下撞击症患者缓解症状有效,但按WORC评估,预计只有不到50%的病例能恢复正常肩部功能。
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