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非手术性合并关节内病变对肩关节粘连性关节囊炎关节镜下关节囊松解术疗效的影响。

Effect of nonoperative concomitant intraarticular pathologies on the outcome of arthroscopic capsular release for adhesive capsulitis of the shoulder.

作者信息

Yildiz Fatih, Sari Abdulkadir, Pulatkan Anil, Ucan Vahdet, Kochai Alauddin, Bilsel Kerem

机构信息

Department of Orthopedics and Traumatology, Bezmialem Vakif University School of Medicine, Istanbul, Turkey.

Department of Orthopedics and Traumatology, Namık Kemal University School of Medicine, Tekirdag, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2018 Jul;52(4):245-248. doi: 10.1016/j.aott.2018.04.002. Epub 2018 Apr 24.

Abstract

OBJECTIVE

The aim of this study was to investigate whether coexistent intraarticular lesions are negative prognostic factors for the results of arthroscopic capsular release in frozen shoulder patients.

METHODS

Seventy-two patients who met inclusion criteria and underwent arthroscopic capsular release between March 2011 and August 2015 for the frozen shoulder were retrospectively evaluated. The patients were divided into two groups according to existence of concomitant intraarticular pathologies detected during arthroscopy. Preoperative and postoperative functional results were assessed with Constant score and shoulder ranges of motion; and the amount of pain was evaluated using visual analog scale (VAS).

RESULTS

Group I consisted of 46 patients (mean age 47.2 years and mean follow-up 26 months) without concomitant shoulder pathologies and group II consisted of 26 patients (mean age 48.6 years and mean follow-up 15 months) with coexistent lesions (SLAP lesions, n = 8; SLAP and partial rupture of the RC, n = 4; SLAP, partial rupture of RC and impingement, n = 10; SLAP and impingement, n = 2; and AC arthritis and impingement, n = 2). Preoperatively, the mean ranges of forward flexion (p = 0.221), abduction (p = 0.065), internal rotation (p = 0.564), Constant (p = 0.148) and VAS (p = 0.365) scores were similar between the groups. After a minimum 12 months of follow-up, all patients significantly improved but no statistically significant difference was detected in the mean ranges of forward flexion (152 vs 150; p = 0.902), abduction (137 vs 129; p = 0.095), external rotation (45 vs 40; p = 0.866), internal rotation (5 vs 5 point; p = 0.474), Constant (82 vs 82.3; p = 0.685) and VAS (1.2 vs 1.2; p = 0.634) scores between the groups.

CONCLUSION

The presence of concomitant shoulder pathologies does not appear to affect the clinical outcomes in patients undergoing arthroscopic capsular release for frozen shoulder.

LEVEL OF EVIDENCE

Level III, Therapeutic study.

摘要

目的

本研究旨在调查合并存在的关节内病变是否为肩周炎患者关节镜下关节囊松解术结果的不良预后因素。

方法

回顾性评估2011年3月至2015年8月间符合纳入标准并接受肩周炎关节镜下关节囊松解术的72例患者。根据关节镜检查时发现的合并关节内病变情况将患者分为两组。术前和术后功能结果采用Constant评分和肩关节活动范围进行评估;疼痛程度采用视觉模拟量表(VAS)进行评估。

结果

第一组由46例患者组成(平均年龄47.2岁,平均随访26个月),无合并肩部病变;第二组由26例患者组成(平均年龄48.6岁,平均随访15个月),存在合并病变(SLAP损伤,n = 8;SLAP和肩袖部分撕裂,n = 4;SLAP、肩袖部分撕裂和撞击征,n = 10;SLAP和撞击征,n = 2;以及肩锁关节炎和撞击征,n = 2)。术前,两组间前屈(p = 0.221)、外展(p = 0.065)、内旋(p = 0.564)、Constant评分(p = 0.148)和VAS评分(p = 0.365)的平均范围相似。经过至少12个月的随访,所有患者均有显著改善,但两组间前屈(152°对150°;p = 0.902)、外展(137°对129°;p = 0.095)、外旋(45°对40°;p = 0.866)、内旋(5分对5分;p = 0.474)、Constant评分(82分对82.3分;p = 0.685)和VAS评分(1.2分对1.2分;p = 0.634)的平均范围未检测到统计学显著差异。

结论

合并肩部病变的存在似乎不影响肩周炎患者接受关节镜下关节囊松解术的临床结果。

证据水平

III级,治疗性研究。

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