肩峰成形术或滑囊切除术对全层肩袖撕裂关节镜修复结果的影响：肩峰类型是否会影响这些结果？
The Effect of Acromioplasty or Bursectomy on the Results of Arthroscopic Repair of Full Thickness Rotator Cuff Tears: Does the Acromion Type Affect These Results?
作者信息
Karakus Ozgun, Gurer Burak, Kilic Selcuk, Sinan Sari Ahmet
机构信息
Department of Orthopedics and Traumatology, Balikesir City Hospital, Balikesir, Turkey.
Department of Orthopedics and Traumatology, Omer Halisdemir University Hospital, Nigde, Turkey.
出版信息
Sisli Etfal Hastan Tip Bul. 2021 Dec 29;55(4):486-494. doi: 10.14744/SEMB.2021.12354. eCollection 2021.
OBJECTIVES
The aim of this study was to investigate the effect of subacromial decompression on the results of full thickness rotator cuff repair applied arthroscopically. Examination was also made of the effect of acromion type on the subacromial decompression procedure in patients applied with arthroscopic rotator cuff repair.
METHODS
The study included a total of 150 patients, comprising 102 (68%) females and 48 (32%) males with a full thickness rotator cuff tear repaired arthroscopically. The patients were separated into three groups of 50. Group A comprised those with acromioplasty and bursectomy applied additional to the repair. In Group B, only bursectomy was performed additional to the repair and in Group C, only rotator cuff repair was applied. Evaluation was made of the post-operative long-term pain and functional results.
RESULTS
The mean age of the cases was 65.63±9.22 years (range, 46-86 years). The affected side was right side in 95 (63.3%) cases and left side in 55 (36.7%). No statistically significant difference was determined between the groups according to the post-operative Constant Murley and ASES scores (p>0.05). In the paired comparisons, the post-operative VAS scores of Group C were higher than those of Groups A and B (p=0.018, p=0.029, p<0.05). No statistically significant difference was determined between Group A and Group B in respect of the post-operative VAS scores (p>0.05).
CONCLUSION
In the arthroscopic repair of full thickness rotator cuff tears, neither acromioplasty, coracoacromial ligament loosening nor bursectomy were determined to have any positive effect on the results. Whatever the acromion type, there is no need for an additional subacromial decompression procedure after rotator cuff repair, in respect of pain and functional outcomes. Only acromial spurs should be gently removed paying attention to the coraco-acromial ligament.
目的
本研究旨在探讨肩峰下减压对关节镜下全层肩袖修复结果的影响。同时还研究了肩峰类型对接受关节镜肩袖修复患者肩峰下减压手术的影响。
方法
本研究共纳入150例患者，其中102例（68%）为女性，48例（32%）为男性，均接受了关节镜下全层肩袖撕裂修复术。患者被分为三组，每组50例。A组在修复的基础上进行了肩峰成形术和滑囊切除术；B组在修复的基础上仅进行了滑囊切除术；C组仅进行了肩袖修复。对术后长期疼痛和功能结果进行评估。
结果
病例的平均年龄为65.63±9.22岁（范围46 - 86岁）。患侧为右侧的有95例（63.3%），左侧的有55例（36.7%）。根据术后Constant Murley和ASES评分，各组之间未发现统计学上的显著差异（p>0.05）。在配对比较中，C组术后VAS评分高于A组和B组（p = 0.018，p = 0.029，p<0.05）。A组和B组术后VAS评分之间未发现统计学上的显著差异（p>0.05）。
结论
在关节镜下全层肩袖撕裂修复中，未发现肩峰成形术、喙肩韧带松解或滑囊切除术对结果有任何积极影响。无论肩峰类型如何，就疼痛和功能结果而言，肩袖修复后无需额外进行肩峰下减压手术。仅应注意喙肩韧带，轻柔地去除肩峰骨赘。
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