射频微切开术：治疗肩袖肌腱病的有前途的方法。
Radiofrequency microtenotomy: a promising method for treatment of rotator cuff tendinopathy.
机构信息
Department of Radiology, University Hospital North Norway, 9038, Tromsö, Norway.
Department of Orthopedics, University Hospital North Norway, 9038, Tromsö, Norway.
出版信息
Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):3856-3863. doi: 10.1007/s00167-019-05689-8. Epub 2019 Aug 31.
PURPOSE
Subacromial pain syndrome is a common disorder. Arthroscopic subacromial decompression is currently the preferred treatment method. Bipolar radiofrequency microtenotomy has shown promising results in treating tendinosis. In this study, the authors compare the results after arthroscopic acromioplasty with bipolar radiofrequency microtenotomy for patients with subacromial pain syndrome.
METHODS
A total of 27 patients, with subacromial pain syndrome, were followed for 2 years. There were 14 patients in the arthroscopic acromioplasty group and 13 patients in the radiofrequency microtenotomy group. Clinical outcome data included pain reported using a visual analog scale, Constant score, and strength. Magnetic resonance imaging of the affected shoulder was performed before and 2 years after intervention for an evaluation of the tendinosis grade.
RESULTS
All patients attended the final follow-up 2 years after intervention. No significant differences were found at baseline between the groups. Pain measured by the visual analog scale revealed a significant reduction in both groups at 12 weeks, 6 months and 2 years compared with baseline. There was no significant difference between the groups in terms of visual analog scale, Constant score, or strength. The magnetic resonance imaging revealed a significant improvement in the tendinosis score in both groups, without any significant difference between the groups.
CONCLUSION
In this prospective randomized study, the clinical assessments revealed a significant improvement in terms of the visual analog scale, strength, Constant score, and tendinosis score 2 years after intervention with either arthroscopic acromioplasty or radiofrequency microtenotomy in patients with subacromial pain syndrome. However, no significant differences were found between the groups. This study reveals that there are surgical options other than acromioplasty in patients with SAPS.
LEVEL OF EVIDENCE
II.
目的
肩峰下疼痛综合征是一种常见疾病。目前，关节镜下肩峰下减压术是首选的治疗方法。双极射频微切开术在治疗肌腱病方面显示出良好的效果。在这项研究中，作者比较了关节镜肩峰成形术与双极射频微切开术治疗肩峰下疼痛综合征患者的结果。
方法
共 27 例肩峰下疼痛综合征患者随访 2 年。其中关节镜肩峰成形术组 14 例，射频微切开术组 13 例。临床结果数据包括疼痛视觉模拟评分、Constant 评分和力量。干预前和干预后 2 年对患肩进行磁共振成像，评估肌腱病程度。
结果
所有患者均在干预后 2 年接受最终随访。两组基线时无显著差异。两组患者在 12 周、6 个月和 2 年时的视觉模拟评分较基线均有显著下降。两组在视觉模拟评分、Constant 评分或力量方面无显著差异。磁共振成像显示两组肌腱病评分均有显著改善，两组间无显著差异。
结论
在这项前瞻性随机研究中，临床评估显示，在肩峰下疼痛综合征患者中，关节镜肩峰成形术或射频微切开术干预 2 年后，视觉模拟评分、力量、Constant 评分和肌腱病评分均有显著改善，但两组间无显著差异。本研究表明，SAP 患者除肩峰成形术外，还有其他手术选择。
证据水平
II 级。
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