Parnes Nata, Bartoszewski Nicole R, Defranco Michael J
Orthopedics. 2018 Jan 1;41(1):e52-e57. doi: 10.3928/01477447-20171114-02. Epub 2017 Nov 21.
This study characterized injury patterns and reported clinical outcomes of all-arthroscopic management of full-thickness rotator cuff tears among military patients younger than 40 years. A retrospective review was performed of prospective data for 42 patients younger than 40 years who underwent arthroscopic rotator cuff repair and, in some cases, concomitant labral repair. Preoperative and postoperative evaluations (minimum follow-up, 2 years; mean, 41 months; range, 24-66 months) included range of motion, visual analog scale (VAS) score, Subjective Shoulder Value (SSV), and American Shoulder and Elbow Surgeons (ASES) Shoulder Score. Of the patients, 97.6% (41 of 42) had improved VAS, SST, and ASES scores. Mean VAS score improved from 8.09±1.51 to 1.19±1.85 (P<.01). Mean SSV improved from 47.88±19.56 to 89.45±14.04 (P<.01). Mean ASES score improved from 38.97±12.70 to 89.88±14.26 (P<.01). No difference for VAS, SSV, and ASES scores was noted between (1) all 42 patients, (2) the 26 patients who had rotator cuff repair but not labral repair, and (3) the 16 patients who had both rotator cuff repair and labral repair. Complications (7.1%; 3 of 42) included 2 postoperatively frozen shoulders and 1 retear of the rotator cuff. Of the patients, 95.2% (40 of 42) returned to their preoperative level of recreational and military job activity. Military patients younger than 40 years who have a full-thickness rotator cuff tear have a high prevalence of concomitant shoulder injury, especially labral tear. For patients younger than 40 years, arthroscopic rotator cuff repair, with or without labral repair, resulted in excellent clinical outcomes, a low risk of complications, and a high rate of return to the preoperative level of recreational and military job activity. [Orthopedics. 2018; 41(1):e52-e57.].
本研究对40岁以下军事患者全层肩袖撕裂的全关节镜治疗的损伤模式及报告的临床结果进行了特征分析。对42例40岁以下接受关节镜肩袖修复且部分病例同时进行盂唇修复的患者的前瞻性数据进行了回顾性分析。术前和术后评估（最短随访2年；平均41个月；范围24 - 66个月）包括活动范围、视觉模拟量表（VAS）评分、主观肩关节评分（SSV）以及美国肩肘外科医师学会（ASES）肩关节评分。97.6%（42例中的41例）患者的VAS、SST和ASES评分有所改善。VAS评分均值从8.09±1.51改善至1.19±1.85（P<0.01）。SSV均值从47.88±19.56改善至89.45±14.04（P<0.01）。ASES评分均值从38.97±12.70改善至89.88±14.26（P<0.01）。在（1）全部42例患者、（2）26例仅进行肩袖修复未进行盂唇修复的患者以及（3）16例同时进行肩袖修复和盂唇修复的患者之间，VAS、SSV和ASES评分未发现差异。并发症发生率为7.1%（42例中的3例），包括2例术后肩周炎和1例肩袖再撕裂。95.2%（42例中的40例）患者恢复到术前的娱乐和军事工作活动水平。40岁以下患有全层肩袖撕裂的军事患者合并肩部损伤的患病率较高，尤其是盂唇撕裂。对于40岁以下患者，无论是否进行盂唇修复，关节镜肩袖修复均能带来优异的临床结果、较低的并发症风险以及较高的恢复到术前娱乐和军事工作活动水平的比率。[《骨科》。2018年；41(1):e52 - e57。]
