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微创喙锁韧带重建的早期临床结果在至少 5 年的随访中得以维持。

Early clinical results of minimally invasive coracoclavicular ligament reconstruction can be maintained at a minimum of five years' follow-up.

机构信息

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Muenster, Westfalian-Wilhelms University Muenster, Muenster, Germany.

Department of Orthopedics and Trauma Surgery, Maria and Josef Hospital, Greven, Germany.

出版信息

Bone Joint J. 2020 Jul;102-B(7):918-924. doi: 10.1302/0301-620X.102B7.BJJ-2020-0114.R1.

Abstract

AIMS

There is a lack of long-term data for minimally invasive acromioclavicular (AC) joint repair. Furthermore, it is not clear if good early clinical results can be maintained over time. The purpose of this study was to report long-term results of minimally invasive AC joint reconstruction (MINAR) and compare it to corresponding short-term data.

METHODS

We assessed patients with a follow-up of at least five years after minimally invasive flip-button repair for high-grade AC joint dislocation. The clinical outcome was evaluated using the Constant score and a questionnaire. Ultrasound determined the coracoclavicular (CC) distance. Results of the current follow-up were compared to the short-term results of the same cohort.

RESULTS

A total of 50 patients (three females, 47 males) were successfully followed up for a minimum of five years. The mean follow-up was 7.7 years (63 months to 132 months). The overall Constant score was 94.4 points (54 to 100) versus 97.7 points (83 to 100) for the contralateral side showing a significant difference for the operated shoulder (p = 0.013) The mean difference in the CC distance between the operated and the contralateral shoulder was 3.7 mm (0.2 to 7.8; p = 0.010). In total, 16% (n = 8) of patients showed recurrent instability. All these cases were performed within the first 16 months after introduction of this technique. A total of 84% (n = 42) of the patients were able to return to their previous occupations and sport activities. Comparison of short-term and long-term results revealed no significant difference for the Constant Score (p = 0.348) and the CC distance (p = 0.974).

CONCLUSION

The clinical outcome of MINAR is good to excellent after long-term follow-up and no significant differences were found compared to short-term results. We therefore suggest this is a reliable technique for surgical treatment of high-grade AC joint dislocation. Cite this article: 2020;102-B(7):918-924.

摘要

目的

微创肩锁关节(AC)修复术缺乏长期数据。此外,目前尚不清楚早期良好的临床效果是否能随着时间的推移而保持。本研究的目的是报告微创 AC 关节重建(MINAR)的长期结果,并将其与相应的短期数据进行比较。

方法

我们评估了至少在微创翻转扣修复高等级 AC 关节脱位后五年以上的随访患者。使用 Constant 评分和问卷评估临床结果。超声确定肩锁关节(CC)距离。将当前随访结果与同一队列的短期结果进行比较。

结果

共有 50 名患者(3 名女性,47 名男性)成功随访至少 5 年。平均随访时间为 7.7 年(63 个月至 132 个月)。总的 Constant 评分为 94.4 分(54 至 100),而对侧为 97.7 分(83 至 100),患肩有显著差异(p = 0.013)。手术肩与对侧肩的 CC 距离平均差异为 3.7 毫米(0.2 至 7.8;p = 0.010)。总共 16%(n = 8)的患者出现复发性不稳定。所有这些病例均在该技术引入后的前 16 个月内进行。共有 84%(n = 42)的患者能够恢复到以前的职业和运动活动。短期和长期结果的比较显示,Constant 评分(p = 0.348)和 CC 距离(p = 0.974)无显著差异。

结论

MINAR 的长期随访临床结果良好至优秀,与短期结果相比无显著差异。因此,我们建议这是一种治疗高等级 AC 关节脱位的可靠技术。

引用本文

2020;102-B(7):918-924.

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