Department of Orthopaedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany.
Department of Trauma Surgery, Hospital of Vöcklabruck, Vöcklabruck, Austria.
Orthop J Sports Med. 2014 May 12;2(5):2325967114533646. doi: 10.1177/2325967114533646. eCollection 2014 May.
Little knowledge exists on postoperative recovery of pain and shoulder function following arthroscopic removal of calcific deposits of the supraspinatus tendon (ACDSSP). Certain factors may influence outcome, including acromial morphology.
To examine postoperative recovery following ACDSSP without acromioplasty and to analyze influential outcome factors.
Case series; Level of evidence, 4.
This prospective study evaluated 82 patients (105 shoulders) after ACDSSP without acromioplasty. Time periods for postoperative recovery of pain and subjective shoulder function were recorded. The absolute and normalized Constant scores (CSabs and CSnorm, respectively), Oxford Shoulder Score (OSS), DASH score (DS), and subjective shoulder value (SSV) were measured after a mean follow-up of 33.9 months. Analyzed outcome factors included localization of the calcific deposit (CD), acromial morphology, radiographic extent of CD removal, type of nonoperative treatment, and preoperative duration of symptoms.
Mean duration of postoperative pain was 2.2 weeks. Recovery of subjective shoulder function required 11.1 weeks on average. Mean ± standard deviation follow-up values were 91.1 ± 8.3 for CSabs, 104.2% ± 8.2% for CSnorm, 13.1 ± 2.6 for OSS, 1.81 ± 4.59 for DS, and 93.8% ± 10.7% for SSV. Abduction was significantly (P = .008) lower in patients with type III (170° ± 17.5°) compared with type I (174° ± 20.7°) and type II (179° ± 4.5°) acromions. Also, abduction was significantly (P = .001) lower in patients with long-standing symptoms (>72 months). Minor calcific remnants were found in 19 of 105 shoulders (18.1%), but affected neither postoperative recovery nor outcome.
ACDSSP without acromioplasty yielded favorable outcomes and effected fast remission of pain regardless of acromial morphology. However, recovery of subjective shoulder function required almost 3 months on average. Minimal restriction of abduction occurred in patients with hook-shaped acromions and long-standing preoperative symptoms. The present data do not support routine performance of acromioplasty.
关于冈上肌腱钙沉积（ACDSSP）关节镜切除术后疼痛和肩部功能的恢复，相关知识有限。某些因素可能会影响结果，包括肩峰形态。
研究不进行肩峰成形术的 ACDSSP 术后的恢复情况，并分析影响结果的因素。
病例系列；证据等级，4 级。
本前瞻性研究评估了 82 例（105 侧）接受 ACDSSP 但不进行肩峰成形术的患者。记录术后疼痛和主观肩部功能的恢复时间。在平均随访 33.9 个月后，测量绝对和标准化的 Constant 评分（CSabs 和 CSnorm）、牛津肩评分（OSS）、DASH 评分（DS）和主观肩部值（SSV）。分析的结果因素包括钙沉积（CD）的定位、肩峰形态、CD 切除的影像学范围、非手术治疗类型以及术前症状持续时间。
术后疼痛的平均持续时间为 2.2 周。平均需要 11.1 周才能恢复主观肩部功能。平均随访值为 CSabs 91.1 ± 8.3、CSnorm 104.2% ± 8.2%、OSS 13.1 ± 2.6、DS 1.81 ± 4.59 和 SSV 93.8% ± 10.7%。与 I 型（174°±20.7°）和 II 型（179°±4.5°）肩峰相比，III 型（170°±17.5°）肩峰患者的外展明显（P =.008）较低。此外，症状持续时间较长（>72 个月）的患者外展也明显（P =.001）较低。105 个肩部中有 19 个（18.1%）发现了较小的钙化残留物，但对术后恢复和结果没有影响。
不进行肩峰成形术的 ACDSSP 可获得良好的结果，并可快速缓解疼痛，与肩峰形态无关。然而，主观肩部功能的恢复平均需要近 3 个月的时间。术前症状持续时间较长和钩状肩峰的患者，外展受限最小。目前的数据不支持常规进行肩峰成形术。
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