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双侧一期关节镜下肩袖修补术与分期手术效果相当:一项为期2年的回顾性随访研究

Bilateral single-staged arthroscopic rotator cuff repair is comparable to staged procedures: a retrospective follow up study of 2 years.

作者信息

Wang Chen, Yang Pu, Zhang Dongfang, Jeon In-Ho, Yu Tengbo, Zhang Yingze, Qi Chao

机构信息

Department of Sports Medicine, the Affiliated Hospital of Qingdao University, Shandong , 266103, Qingdao, P.R. China.

Department of Orthopedic Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-ro 43-gil, Songpa-gu, 05505, Seoul, Republic of Korea.

出版信息

BMC Musculoskelet Disord. 2021 May 4;22(1):409. doi: 10.1186/s12891-021-04304-7.

Abstract

BACKGROUND

Bilateral rotator cuff tears are not uncommon and the timing of the surgical treatment of both shoulders is debated. In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair.

METHODS

From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. Patients were separated into 2 groups: single-stage and staged. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, the range of motion (ROM) of the shoulder and the hospitalization costs were evaluated for comparison between the two groups before and after the operation. Differences between groups were assessed using t-tests and ANOVA.

RESULTS

All 51 patients completed follow-up of 2 years, single stage (n = 24) and staged group (n = 27). There was no significant difference in the VAS, ASES, UCLA and Constant scores between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups (P < 0.05). All outcome scores were significantly different between the two groups at 6 months postoperatively, and the staged scored better than the single-stage (P < 0.05). At 12, 18, and 24 months after the operation, the outcome scores were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. In the single-stage group, the outcome scores and ROM were similar for both shoulders and comparable to the staged group. We also found significant cost savings in the single-stage group (4440.89 ± 130.55 USD) compared to the staged group (5065.73 ± 254.76 USD) (p < 0.05).

CONCLUSIONS

Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-ups longer than 6 months. Moreover, good outcomes were observed on both sides of the single-stage group.

摘要

背景

双侧肩袖撕裂并不罕见,且双侧肩部手术治疗的时机存在争议。在本研究中,我们旨在比较接受一期或分期双侧关节镜下肩袖修复术患者的临床疗效。

方法

对2013年3月至2018年5月在我科接受双侧关节镜下肩袖修复术的所有患者进行回顾性研究。患者分为两组:一期组和分期组。最小随访期为2年。评估视觉模拟量表(VAS)、美国肩肘外科医师学会(ASES)评分、加利福尼亚大学洛杉矶分校(UCLA)评分、康斯坦特-默里(Constant)评分、肩部活动范围(ROM)及住院费用,以比较两组手术前后的情况。组间差异采用t检验和方差分析进行评估。

结果

51例患者均完成了2年随访,一期组(n = 24)和分期组(n = 27)。术前一期组和分期组的VAS、ASES、UCLA和Constant评分无显著差异。两组术后临床评分均显著改善(P < 0.05)。术后6个月时,两组所有结局评分均有显著差异,分期组评分优于一期组(P < 0.05)。术后12、18和24个月时,两组结局评分无显著差异。随访时,两组肩部ROM无显著差异。在一期组中,双肩的结局评分和ROM相似,且与分期组相当。我们还发现,与分期组(5065.73 ± 254.76美元)相比,一期组显著节省了费用(4440.89 ± 130.55美元)(p < 0.05)。

结论

接受一期或分期双侧关节镜下肩袖修复术的患者在随访时间超过6个月时显示出相似的良好临床疗效。此外,一期组双侧均观察到良好疗效。

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