Trantalis John N, Sohmer Stephen, More Kristie D, Nelson Atiba A, Wong Ben, Dyke Corinne H, Thornton Gail M, Boorman Richard S, Lo Ian K Y
Department of Orthopaedics, Concord Public Hospital, Concord, NSW 2137, Australia.
Department of Surgery, Campbell River Hospital, 375 2nd Avenue, Campbell River, BC V9W 3V1, Canada.
Int J Shoulder Surg. 2015 Jul-Sep;9(3):74-80. doi: 10.4103/0973-6042.161434.
The aim was to evaluate the clinical and anatomic outcome of arthroscopic repair of type II SLAP lesions.
The senior author performed isolated repairs of 25 type II SLAP lesions in 25 patients with a mean age of 40.0 ± 12 years. All tears were repaired using standard arthroscopic suture anchor repair to bone. All patients were reviewed using a standardized clinical examination by a blinded, independent observer, and using several shoulder outcome measures. Patients were evaluated by magnetic resonance imaging arthrogram at a minimum of 1-year postoperatively.
Two-tailed paired t-test were used to determine significant differences in preoperative and postoperative clinical outcomes scores. In addition, a Fisher's exact test was used.
At a mean follow-up of 54-month, the mean American Shoulder and Elbow Surgeons Shoulder Index (ASES) scores improved from 52.1 preoperatively to 86.1 postoperatively (P < 0.0001) and the Simple Shoulder Test (SST) scores from 7.7 to 10.6 (P < 0.0002). Twenty-two out of the 25 patients (88%) stated that they would have surgery again. Of the 21 patients who had postoperative magnetic resonance imaging arthrographys (MRAs), 9 patients (43%) demonstrated dye tracking between the labrum bone interface suggestive of a recurrent tear and 12 patients (57%) had a completely intact repair. There was no significant difference in ASES, SST, and patient satisfaction scores in patients with recurrent or intact repairs.
Arthroscopic repair of type II SLAP lesions demonstrated improvements in clinical outcomes. However, MRA imaging demonstrated 43% of patients with recurrent tears. MRA results do not necessarily correlate with clinical outcome.
评估关节镜下修复Ⅱ型肩胛下肌前上盂唇(SLAP)损伤的临床和解剖学结果。
资深作者对25例平均年龄为40.0±12岁的患者的25处Ⅱ型SLAP损伤进行了单独修复。所有撕裂均采用标准关节镜缝线锚钉固定修复至骨。所有患者均由一名不知情的独立观察者进行标准化临床检查,并采用多种肩部结局指标进行评估。患者在术后至少1年接受磁共振关节造影评估。
采用双尾配对t检验确定术前和术后临床结局评分的显著差异。此外,还使用了Fisher精确检验。
平均随访54个月时,美国肩肘外科医师学会(ASES)肩部指数平均得分从术前的52.1提高到术后的86.1(P<0.0001),简单肩部测试(SST)得分从7.7提高到10.6(P<0.0002)。25例患者中有22例(88%)表示愿意再次接受手术。在21例进行了术后磁共振关节造影(MRA)的患者中,9例(43%)显示造影剂在盂唇骨界面之间追踪,提示复发性撕裂,12例(57%)修复完全完整。复发性或完整修复患者的ASES、SST和患者满意度评分无显著差异。
关节镜下修复Ⅱ型SLAP损伤显示临床结局有所改善。然而,MRA成像显示43%的患者存在复发性撕裂。MRA结果不一定与临床结局相关。