Hollman Freek, Wolterbeek Nienke, Zijl Jacco A C, van Egeraat Sjoerd P M, Wessel Ronald N
Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
Arthroscopy. 2017 Sep;33(9):1618-1626. doi: 10.1016/j.arthro.2017.02.010. Epub 2017 Apr 17.
To study the effects on pain as the main outcome parameter and on function and cuff integrity as the secondary outcome parameters after arthroscopic rotator cuff repair in the short term comparing the abduction brace with an antirotation sling for postoperative shoulder immobilization.
Eligible patients were between the ages of 18 and 75 years who were diagnosed with a traumatic or degenerative tear of the supraspinatus and/or infraspinatus tendon, confirmed by magnetic resonance imaging, for which an arthroscopic footprint repair was indicated and performed. Patients were randomly allocated to the antirotation sling or abduction brace group. Postoperative pain and use of analgesics were accurately registered up to 3 months after surgery using a patient diary. Follow-up examinations including the Constant-Murley score, Western Ontario Rotator Cuff index, and glenohumeral range of motion were scheduled 6 weeks, 3 and 6 months, and 1 year after surgery.
The average level of pain measured directly postoperation up to 1 year after surgery was not significant different between groups. Postoperatively, function scores and glenohumeral range of motion improved significantly for both groups; however, no differences were observed between groups. No retears were observed on ultrasonograph 3 months after surgery.
In the short term, the level of pain, function, and quality of life were not significantly different between the use of an abduction brace and that of an antirotation sling after arthroscopic rotator cuff repair. Based on these findings, the abduction brace used in this study does not seem to be the solution for decreasing the pain experienced in the first postoperative weeks after arthroscopic rotator cuff repair, and both are recommendable.
Level I, randomized controlled trial.
比较外展支具与抗旋转吊带在关节镜下肩袖修补术后短期用于肩部固定时,对以疼痛为主要结局参数以及对功能和袖带完整性为次要结局参数的影响。
符合条件的患者年龄在18至75岁之间,经磁共振成像确诊为冈上肌和/或冈下肌腱创伤性或退行性撕裂,需行关节镜下足迹修复术并已实施。患者被随机分配至抗旋转吊带组或外展支具组。术后使用患者日记准确记录术后3个月内的疼痛情况及镇痛药使用情况。术后6周、3个月、6个月及1年安排随访检查,包括Constant-Murley评分、西安大略肩袖指数和盂肱关节活动范围。
术后直至术后1年直接测量的平均疼痛水平在两组间无显著差异。术后两组的功能评分和盂肱关节活动范围均显著改善;然而,两组间未观察到差异。术后3个月超声检查未发现再撕裂。
在短期内,关节镜下肩袖修补术后使用外展支具和抗旋转吊带在疼痛程度、功能及生活质量方面无显著差异。基于这些发现,本研究中使用的外展支具似乎并非减轻关节镜下肩袖修补术后最初几周疼痛的解决方案,两种方法均值得推荐。
I级,随机对照试验。