Ji Xiaoxi, Ye Lingchao, Hua Yinghui, Zhou Xiaobo
Huashan Hospital, Fudan University, Shanghai, China.
Zhejiang Taizhou Hospital, Taizhou, China.
Orthop J Sports Med. 2020 Dec 16;8(12):2325967120969213. doi: 10.1177/2325967120969213. eCollection 2020 Dec.
Older patients with shoulder instability have a higher prevalence of rotator cuff tears and anterior capsular lesions. Simultaneous rotator cuff repair and labral repair are commonly performed to improve shoulder stability and function.
To investigate the clinical outcomes of arthroscopic rotator cuff repair for older patients with shoulder dislocations combined with massive rotator cuff tears and intact labral tissue.
Case series; Level of evidence, 3.
A cohort consisting of 11 patients older than 50 years with shoulder dislocations and massive rotator cuff tears undergoing arthroscopic rotator cuff repair was identified between December 2015 and January 2018. Rotator cuff repair was performed after Bankart, superior labral anterior-posterior, and humeral avulsion of the glenohumeral ligament lesions were excluded during arthroscopic surgery. Preoperative and 12-month postoperative outcomes including modified University of California Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), Western Ontario Shoulder Instability Index (WOSI), and visual analog scale for pain scores as well as range of motion (ROM) were recorded.
The supraspinatus tendon was torn in all patients. Also, 36.4% of the patients had 3 rotator cuff tendons torn. For shoulder function, the preoperative UCLA score (12.1 ± 2.5 [range, 9-16]) and ASES score (35.4 ± 12.7 [range, 24-44]) significantly improved to 29.4 ± 4.3 (range, 24-35; < .001) and 79.4 ± 16.0 (range, 45-95; < .001), respectively, at 12 months postoperatively. None of the patients experienced shoulder redislocations at 12 months after surgery. For shoulder stability, the postoperative WOSI score (156.8 ± 121.0 [range, 45-365]) was significantly better than was the preoperative score (713.0 ± 238.6 [range, 395-1090]) ( < .001). For comparisons between preoperative and postoperative ROM, forward flexion, abduction, and external and internal rotation at the side significantly improved.
For patients older than 50 years with shoulder dislocations combined with massive rotator cuff tears and an intact labrum, arthroscopic rotator cuff repair alone achieved satisfactory functional outcomes and ROM without the recurrence of dislocations.
老年肩部不稳定患者肩袖撕裂和前关节囊损伤的患病率较高。同时进行肩袖修复和盂唇修复通常用于改善肩部稳定性和功能。
探讨关节镜下肩袖修复术治疗老年肩关节脱位合并巨大肩袖撕裂且盂唇组织完整患者的临床疗效。
病例系列；证据等级，3级。
确定2015年12月至2018年1月期间11例年龄大于50岁、肩关节脱位且有巨大肩袖撕裂并接受关节镜下肩袖修复术的患者。在关节镜手术期间排除Bankart损伤、上盂唇前后部损伤和盂肱韧带肱骨撕脱损伤后进行肩袖修复。记录术前和术后12个月的结果，包括改良的加利福尼亚大学洛杉矶分校（UCLA）评分、美国肩肘外科医师学会（ASES）评分、西安大略肩不稳定指数（WOSI）、疼痛视觉模拟评分以及活动范围（ROM）。
所有患者的冈上肌腱均有撕裂。此外，36.4%的患者有3条肩袖肌腱撕裂。对于肩部功能，术前UCLA评分（12.1±2.5[范围，9 - 16]）和ASES评分（35.4±12.7[范围，24 - 44]）在术后12个月时分别显著提高至29.4±4.3（范围，24 - 35；P <.001）和79.4±16.0（范围，45 - 95；P <.001）。术后12个月时无患者出现肩关节再脱位。对于肩部稳定性，术后WOSI评分（156.8±121.0[范围，45 - 365]）明显优于术前评分（713.0±
