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关节镜下肩胛胸壁囊切除术和部分上内侧角肩胛切除术的功能结果。

Functional Outcomes After Arthroscopic Scapulothoracic Bursectomy and Partial Superomedial Angle Scapulectomy.

机构信息

The University of Utah, Salt Lake City, Utah, USA.

出版信息

Orthop J Sports Med. 2013 Oct 8;1(5):2325967113505739. doi: 10.1177/2325967113505739. eCollection 2013 Oct.

Abstract

BACKGROUND

Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy has been described as a treatment for persistent scapulothoracic bursitis with varying results.

PURPOSE

To evaluate patients after arthroscopic scapulothoracic bursectomy utilizing validated functional outcome instruments.

STUDY DESIGN

Case series.

METHODS

Fifteen patients underwent arthroscopic scapulothoracic bursectomy and partial superomedial angle scapulectomy. Thirteen patients were available for review at a mean 27-month follow-up (range, 13-65 months). Patients were evaluated preoperatively with a history, physical examination evaluating medial scapula border tenderness and crepitus, pain visual analog scale (VAS) score, and the simple shoulder test (SST). Postoperatively, patients were evaluated with all preoperative questionnaires as well as a satisfaction survey and the American Shoulder and Elbow Surgeons (ASES) score.

RESULTS

SST scores improved significantly from a mean 7.7 ± 3.1 preoperatively to 10.3 ± 2.3 postoperatively (P = .03). VAS pain scores reduced significantly from 6.5 ± 2.2 preoperatively to 2.3 ± 2.4 postoperatively (P < .001). Ninety-two percent (12/13) of patients were satisfied, and 92% (12/13) stated they would have the surgical procedure performed again. The mean ASES postoperative score was 80.1 (range, 38-100). The 2 clinical failures (ASES scores <50) had either a workers' compensation claim with persistent medial border tenderness or ongoing rotator cuff disease. Despite lower ASES scores, these patients were still satisfied with the procedure and would undergo it again.

CONCLUSION

Arthroscopic scapulothoracic bursectomy with partial superomedial angle scapulectomy provides significant improvements in pain and functional outcomes. Even in patients at risk for poorer clinical outcomes, patient satisfaction and willingness to undergo the surgical procedure again was still high.

摘要

背景

关节镜下肩胛胸壁滑囊炎切除术联合肩胛上内角部分切除术已被描述为治疗持续性肩胛胸壁滑囊炎的一种方法,但结果各不相同。

目的

利用有效的功能评估工具评估关节镜下肩胛胸壁滑囊炎切除术后的患者。

研究设计

病例系列研究。

方法

15 例患者接受了关节镜下肩胛胸壁滑囊炎切除术和肩胛上内角部分切除术。13 例患者在平均 27 个月的随访(范围 13-65 个月)时可进行评估。术前通过病史、评估内侧肩胛缘压痛和弹响的体格检查、疼痛视觉模拟评分(VAS)和简易肩部测试(SST)进行评估。术后,所有患者均接受术前所有问卷评估、满意度调查以及美国肩肘外科医生协会(ASES)评分。

结果

SST 评分从术前的平均 7.7±3.1 显著改善至术后的 10.3±2.3(P=.03)。VAS 疼痛评分从术前的 6.5±2.2 显著降低至术后的 2.3±2.4(P<.001)。92%(12/13)的患者满意,92%(12/13)的患者表示会再次接受手术。术后平均 ASES 评分为 80.1(范围 38-100)。2 例(ASES 评分<50)手术失败患者均存在持续的内侧边界压痛或持续性肩袖疾病,存在工人赔偿索赔。尽管 ASES 评分较低,但这些患者仍对手术满意,并愿意再次接受手术。

结论

关节镜下肩胛胸壁滑囊炎切除术联合肩胛上内角部分切除术可显著改善疼痛和功能结果。即使在临床结果较差的患者中,患者满意度和再次接受手术的意愿仍然很高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/775d/4555498/486dc6d388b2/10.1177_2325967113505739-fig1.jpg

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