Sun Chao, Pan Zhaoxun, Yang Xiaoming, Du Bencai
Department of Joint Surgery, the 89th Hospital of Chinese PLA, Weifang Shandong, 261021, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 Aug 8;30(8):943-946. doi: 10.7507/1002-1892.20160191.
To investigate the effectiveness of reversed arthroscopic subacromial decompression in the treatment of rotator cuff tears.
Between November 2012 and January 2015, 53 patients with rotator cuff tears were treated with reversed arthroscopic subacromial decompression and rotator cuff repair. Of 53 patients, 38 were male and 15 were female, with the age of 47-61 years (mean, 53.4 years). The injury was caused by falling in 36 cases and other in 17 cases without an obvious history of trauma. All patients had shoulder pain and limited shoulder movement before operation. Visual analogue scale (VAS) was 6.4±0.9, and University of California at Los Angeles (UCLA) score was 16.3±1.9. MRI showed that distal supraspinatus tear was observed in 41 cases and distal infraspinatus tear in 12 cases; partial-thickness rotator cuff tear was observed in 9 cases and full-thickness tear in 44 cases. And the tear size was from 1 to 3 cm (mean, 1.9 cm). Combined injuries included tendinitis of long head of biceps brachii in 31 cases, Bankart lesion in 5 cases, and superior labrum anterior and posterior lesion in 2 cases.
Incision healed by first intention in all patients; no infection or nerve injury occurred. Forty-nine cases were followed up from 12 to 35 months (mean, 22.8 months). After operation, shoulder pain relief was achieved in 42 cases; 7 cases had anterior shoulder pain at 3 months after operation, which was relieved after symptomatic treatment. At last follow-up, VAS score was significantly decreased to 0.5±0.6 (=40.565, =0.000). UCLA score was significantly increased to 33.8±1.7 (=-79.799, =0.000). The results were excellent in 42 cases, good in 6 cases, and fair in 1 case; the excellent and good rate was 98.0%.
Reversed arthroscopic subacromial decompression can avoid coracoacromial arch injury and achieve good recovery of joint function, so it can be used in rotator cuff tears procedure.
探讨关节镜下反向肩峰下减压术治疗肩袖损伤的疗效。
2012年11月至2015年1月，对53例肩袖损伤患者行关节镜下反向肩峰下减压及肩袖修复术。53例患者中，男38例，女15例，年龄47 - 61岁（平均53.4岁）。损伤原因：跌倒致伤36例，无明显外伤史17例。所有患者术前均有肩部疼痛及活动受限。视觉模拟评分（VAS）为6.4±0.9，加利福尼亚大学洛杉矶分校（UCLA）评分16.3±1.9。MRI显示：冈上肌远端撕裂41例，冈下肌远端撕裂12例；肩袖部分厚度撕裂9例，全层撕裂44例。撕裂大小为1～3 cm（平均1.9 cm）。合并损伤包括肱二头肌长头肌腱炎31例，Bankart损伤5例，上盂唇前后方损伤2例。
所有患者切口均一期愈合，无感染及神经损伤发生。49例获随访，随访时间12～35个月（平均22.8个月）。术后42例肩部疼痛缓解；7例术后3个月出现肩部前方疼痛，经对症治疗后缓解。末次随访时，VAS评分显著降至0.5±0.6（=40.565，=0.000）。UCLA评分显著升至33.8±1.7（=-79.799，=0.000）。结果优42例，良6例，可1例；优良率为98.0%。
关节镜下反向肩峰下减压术可避免喙肩弓损伤，关节功能恢复良好，可用于肩袖损伤手术。
