Athens Kolonaki Orthopaedic and Sports Medicine Center, Athens, Greece.
Athens Kolonaki Orthopaedic and Sports Medicine Center, Athens, Greece.
Arthroscopy. 2018 Sep;34(9):2552-2557. doi: 10.1016/j.arthro.2018.03.046. Epub 2018 Jun 21.
To compare the clinical outcomes and return to sport rate between elite overhead athletes who underwent shoulder arthroscopy and decompression of the suprascapular nerve (SSN) versus overhead athletes who underwent shoulder arthroscopy without SSN release.
From 2007 to 2014, high-level overhead athletes diagnosed with a rotator cuff tear and/or a glenoid labral lesion and SSN entrapment were included in the study if their symptoms did not improve with nonoperative treatment and if they agreed to undergo surgery and participate. Their preoperative University of California at Los Angeles (UCLA) shoulder score, bilateral postoperative Constant scores, postoperative UCLA score, and return to sport rate were evaluated and compared with those of a group of elite athletes who had a similar diagnosis but refused to undergo SSN decompression during shoulder arthroscopy.
Thirty-five athletes (25 male, 10 female) were included in the SSN decompression group (group 1), and 21 athletes were included in the non-SSN decompression group (group 2). The mean age was 27 years (range: 19-34) and 24 years (range: 21-32) in group 1 and group 2, respectively (P = .56). The mean follow-up time was 38.4 months (24-50 months) in group 1 and 42.2 months (26-53 months) in group 2 (P = .09). Both groups had significantly improved UCLA scores after surgery (P < .05). The postoperative UCLA (P = .01) and Constant scores (P < .001) were significantly higher in the SSN decompression group. The mean difference in Constant score between the affected and the unaffected side was 4 points (range: 2-12) in the SSN decompression group and 8 points (range: 4-14) in the non-SSN decompression group postoperatively (P = .0002). In both groups, 100% of patients reached the patient acceptable symptom state value for Constant score at follow-up. For the UCLA score, patients who underwent SSN decompression had significantly higher pre- to postoperative improvement than the nondecompression group (P = .016). The return to sport rate was 97% in group 1 and 84% in group 2. The mean length of career was 2.1 years (range: 1.5-2.4 years) and 2.3 years (range: 1.2-3.2 years) in group 1 and group 2, respectively.
In elite overhead athletes with shoulder pathology and SSN entrapment, combined shoulder arthroscopy and SSN release yield superior clinical outcomes, greater improvement in UCLA score, and a higher return to sport rate than shoulder arthroscopy without SSN decompression. Regardless of SSN treatment, both groups achieved the patient acceptable symptom state after shoulder arthroscopy.
Level III, comparative case series.
比较行肩关节镜下手术并同时行肩胛上神经（SSN）减压与单纯行肩关节镜下手术的精英上肢运动员的临床结果和重返运动率。
自 2007 年至 2014 年，对接受过手术且愿意参与研究的、患有肩袖撕裂和/或盂唇病变且存在 SSN 卡压、经非手术治疗后症状未改善的高水平上肢运动员，行肩关节镜下 SSN 减压术或单纯肩关节镜下手术。评估并比较他们术前加利福尼亚大学洛杉矶分校（UCLA）肩部评分、双侧术后Constant 评分、术后 UCLA 评分和重返运动率，并与一组因类似诊断而拒绝行 SSN 减压的精英运动员进行比较。
35 名运动员（25 名男性，10 名女性）纳入 SSN 减压组（组 1），21 名运动员纳入非 SSN 减压组（组 2）。组 1和组 2的平均年龄分别为 27 岁（范围：19-34 岁）和 24 岁（范围：21-32 岁）（P=0.56）。组 1和组 2的平均随访时间分别为 38.4 个月（24-50 个月）和 42.2 个月（26-53 个月）（P=0.09）。两组术后 UCLA 评分均显著提高（P＜0.05）。SSN 减压组术后 UCLA（P=0.01）和 Constant 评分（P＜0.001）显著更高。SSN 减压组术后Constant 评分患侧与健侧差值为 4 分（范围：2-12），非减压组为 8 分（范围：4-14）（P=0.0002）。两组患者术后均达到了 Constant 评分的患者可接受症状状态值。在 UCLA 评分方面，行 SSN 减压的患者术后改善情况明显优于非减压组（P=0.016）。组 1的重返运动率为 97%，组 2为 84%。组 1和组 2的平均运动生涯长度分别为 2.1 年（范围：1.5-2.4 年）和 2.3 年（范围：1.2-3.2 年）。
对于患有肩部疾病和 SSN 卡压的精英上肢运动员，行肩关节镜下手术联合 SSN 松解可获得更好的临床结果，UCLA 评分的改善更大，重返运动率更高，优于单纯行肩关节镜下手术而不松解 SSN。无论是否行 SSN 治疗，两组患者在接受肩关节镜手术后均达到了患者可接受的症状状态。
III 级，比较病例系列研究。
