Miyazaki Alberto Naoki, Fregoneze Marcelo, da Silva Luciana Andrade, do Val Sella Guilherme, Garotti José Eduardo Rosseto, Checchia Sergio Luiz
Department of Orthopedics and Traumatology, Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, Brazil.
Rev Bras Ortop. 2015 Jun 24;50(4):389-94. doi: 10.1016/j.rboe.2015.06.008. eCollection 2015 Jul-Aug.
To evaluate the functional results from patients with arthrosis who underwent an arthroscopic procedure, in an attempt to correlate these results with the patients' epidemiological profile, surgical technique used, possible complications and postoperative protocol.
Between 1998 and 2011, 31 patients (32 shoulders) with shoulder arthrosis underwent arthroscopic treatment performed by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology of Santa Casa de São Paulo. Primary or secondary cases of shoulder arthrosis under the age of 70 years, in which the rotator cuff was intact, were included. Furthermore, cases in which, despite an indication for an arthroplastic procedure, an attempt to perform an alternative procedure had been chosen, were also included. The following were evaluated: sex, age, dominance, comorbidities, length of time with complaint, associated lesions, etiology, previous treatment, operation performed, postoperative protocol and pre and postoperative active ranges of motion. The functional evaluation was conducted using the UCLA criteria, before and after the operation. The joint cartilage alterations were classified in accordance with Outerbridge and the arthrosis by means of Walch.
There were statistically significant mean differences in the values for elevation, lateral rotation and medial rotation from before to after the operation (p < 0.001) and there was a tendency (p = 0.057) toward poor results with greater length of time with complaints before the surgery. The total gain in UCLA score did not have any statistically significant relationship with any of the other variables analyzed.
Arthroscopic treatment of glenohumeral arthrosis provided functional improvement of the glenohumeral joint, with significant gains in elevation and lateral and medial rotation, and improvements in function and pain. Greater length of time with complaints was a factor strongly suggestive of worse results.
评估接受关节镜手术的骨关节炎患者的功能结果，试图将这些结果与患者的流行病学特征、所采用的手术技术、可能的并发症及术后方案相关联。
1998年至2011年期间，圣保罗圣卡塔琳娜医院骨科与创伤科肩肘组对31例（32个肩部）肩关节骨关节炎患者进行了关节镜治疗。纳入70岁以下的原发性或继发性肩关节骨关节炎患者，其肩袖完整。此外，还纳入了尽管有进行关节置换手术的指征，但选择尝试替代手术的病例。评估了以下内容：性别、年龄、利手、合并症、主诉时间、相关病变、病因、既往治疗、所实施的手术、术后方案以及术前和术后的主动活动范围。使用UCLA标准在手术前后进行功能评估。根据Outerbridge对关节软骨改变进行分类，根据Walch对骨关节炎进行分类。
术后抬高、外旋和内旋的值与术前相比存在统计学上的显著差异（p < 0.００1），并且术前主诉时间越长，结果越差的趋势（p = 0.057）。UCLA评分的总增益与所分析的任何其他变量均无统计学上的显著关系。
肩关节骨关节炎的关节镜治疗可改善肩关节功能，在抬高、外旋和内旋方面有显著改善，功能和疼痛也有所改善。主诉时间越长是结果较差的一个强烈提示因素。
