Gokkus K, Saylik M, Atmaca H, Sagtas E, Aydin A T
Orthopaedics and Trauma, Ozel Antalya Memorial Hospital, zafer mah .yildirim beyazit cad no 91, Kepez Antalya, 07025, Turkey.
Orthopaedics and Trauma department, Ozel Bursa Bahar Hospita, Bursa, Turkey.
Orthop Traumatol Surg Res. 2016 May;102(3):311-8. doi: 10.1016/j.otsr.2016.01.008. Epub 2016 Mar 8.
Resection of the distal aspect of clavicle has a well-documented treatment modality in case of acromioclavicular joint osteoarthritis resistant to conservative treatment.
Limited (mean ∼0.5cm distal end of clavicle resection) distal clavicle excision of A-C joint arthritis in cases resistant to conservative treatment may reduce the pain and improve the shoulder function.
In this study, we retrospectively evaluated the results of limited distal clavicle excision of acromioclavicular joint osteoarthritis resistant to conservative treatment. All patients were evaluated by using the Visual Analogue Scale (VAS) and UCLA shoulder rating scale (University of California Los Angeles), either before surgery or final follow-up period for pain and functional results, respectively.
A total of 110 patients (48 male, 62 female) with AC joint arthritis, treated between the years of 2008-2012, were retrospectively analyzed. A total of 30 patients (12 male, 18 female) who failed to show improvement with conservative treatment underwent limited surgical open excision of distal clavicle. The mean age of the study population was 52.5±1.2 years. The mean follow-up period was 27±1.3 months. The mean preoperative VAS score was 83.6±5.58 (range, 70-90) while mean VAS was 26.6±9.3 (range, 10-50) at the final follow-up. There was a statistically significant difference between pre- and postoperative VAS scores in patients who had treated by surgical approach (P<0.001). The mean UCLA score of the patients increased postoperatively from 11.5 (range, 9-14) to 29.2 (range, 27-32) at the final follow-up. There was a statistically significant difference between the two time periods with respect to UCLA scores (P<0.001).
In patients with AC osteoarthritis resistant to conservative therapy, the hypothesized limited clavicle excision (mean ∼0.5cm distal end of clavicle resection with preserving coracoclavicular ligaments and inferior capsule) reduced the pain and improved the shoulder function.
Our midterm follow-up (mean 27 months) results showed that limited distal clavicle excision of patients with AC joint osteoarthritis resistant to conservative treatment (0.5cm distal end of clavicle resection with preserving inferior capsule, and coracoclavicular ligaments) reduced the pain and improved the shoulder function.
IV (Retrospective study).
对于保守治疗无效的肩锁关节骨关节炎，锁骨远端切除术是一种有充分文献记载的治疗方式。
对于保守治疗无效的肩锁关节骨关节炎患者，进行有限的（平均锁骨远端切除约0.5厘米）锁骨远端切除术可减轻疼痛并改善肩部功能。
在本研究中，我们回顾性评估了对保守治疗无效的肩锁关节骨关节炎患者进行有限锁骨远端切除术的结果。所有患者分别在手术前或最终随访期通过视觉模拟量表（VAS）和加州大学洛杉矶分校（UCLA）肩部评分量表评估疼痛和功能结果。
对2008年至2012年间接受治疗的110例肩锁关节骨关节炎患者（48例男性，62例女性）进行了回顾性分析。共有30例（12例男性，18例女性）经保守治疗无效的患者接受了有限的锁骨远端开放性手术切除。研究人群的平均年龄为52.5±1.2岁。平均随访期为27±1.3个月。术前平均VAS评分为83.6±5.58（范围70 - 90），而最终随访时平均VAS为26.6±9.3（范围10 - 50）。手术治疗患者的术前和术后VAS评分存在统计学显著差异（P<0.001）。患者的UCLA评分在术后从11.5（范围9 - 14）提高到最终随访时的29.2（范围27 - 32）。两个时间段的UCLA评分存在统计学显著差异（P<0.001）。
对于保守治疗无效的肩锁关节骨关节炎患者，假设的有限锁骨切除术（平均锁骨远端切除约0.5厘米，保留喙锁韧带和下关节囊）减轻了疼痛并改善了肩部功能。
我们的中期随访（平均27个月）结果表明，对保守治疗无效的肩锁关节骨关节炎患者进行有限的锁骨远端切除术（锁骨远端切除0.5厘米，保留下关节囊和喙锁韧带）减轻了疼痛并改善了肩部功能。
IV（回顾性研究）
