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关节镜下肱二头肌长头转移与肌腱固定治疗不可修复性肩袖撕裂的临床疗效。

Clinical effect of arthroscopic long head of biceps transfer and tenodesis on irreparable rotator cuff tear.

机构信息

Department of Joint and Sports Medicine, East Hospital, Tongji University School of Medicine, 150 Jimo Road, Pudong New Area, Shanghai City, 200120, People's Republic of China.

出版信息

J Orthop Surg Res. 2022 Apr 10;17(1):220. doi: 10.1186/s13018-022-03121-5.

Abstract

OBJECTIVE

To explore the clinical effect of arthroscopic long head of biceps transfer and tenodesis for on irreparable rotator cuff tear.

METHODS

A total of 18 patients with irreparable rotator cuff tear who were treated in the Dongfang Hospital Affiliated to Tongji University School of Medicine from April 2018 to March 2020 were included in this study. They all underwent arthroscopic long head of biceps transfer and tenodesis. Shoulder joint motions (forward flexion, abduction, and external rotation angle) and magnetic resonance imaging (MRI) were performed. Moreover, visual analogue scale (VAS) and university of California Los Angeles (UCLA) score were conducted during follow-up.

RESULTS

Preoperative symptoms lasted from 3 to 16 months, with an average duration of 10 months. All patients healed in the first stage without obvious complications were included. All patients were followed up for 4 to 14 months after the surgery, with an average duration of 11.1 months. The range of shoulder joint motions, including forward flexion (80.52° ± 31.19° vs. 149.47° ± 28.36°), abduction (65.13° ± 37.59° vs. 152.46° ± 28.64°) and lateral rotation (30.17° ± 15.15° vs. 71.49° ± 11.42°) was significantly improved after operation (P < 0.05). The VAS score was notably decreased after operation (8.46 ± 0.80 vs. 1.55 ± 0.70), but the UCLA score was markedly increased (15.27 ± 2.89 vs. 31.17 ± 2.36). MRI imaging showed that 15 patients had good tissue healing, with a healing rate of 83.3% (15/18).

CONCLUSION

Arthroscopy of the biceps long head tendon transposition can significantly relieve pain in patients with large rotator cuff tears, improve joint mobility, and restore joint function.

摘要

目的

探讨关节镜下肱二头肌长头转位及固定治疗不可修复性肩袖撕裂的临床效果。

方法

选取 2018 年 4 月至 2020 年 3 月在同济大学附属东方医院接受关节镜下肱二头肌长头转位及固定治疗的 18 例不可修复性肩袖撕裂患者,均采用关节镜下肱二头肌长头转位及固定治疗。术后随访观察肩关节活动度(前屈、外展和外旋角度)及磁共振成像(MRI),采用视觉模拟评分(VAS)和加利福尼亚大学洛杉矶分校(UCLA)评分评估疗效。

结果

术前症状持续时间 316 个月,平均 10 个月。所有患者均一期愈合,无明显并发症,均纳入随访。术后随访 414 个月,平均 11.1 个月。术后肩关节活动度中前屈(80.52°±31.19°比 149.47°±28.36°)、外展(65.13°±37.59°比 152.46°±28.64°)和外旋(30.17°±15.15°比 71.49°±11.42°)明显改善(P<0.05)。术后 VAS 评分明显降低(8.46±0.80 比 1.55±0.70),UCLA 评分明显升高(15.27±2.89 比 31.17±2.36)。MRI 检查示 15 例患者组织愈合良好,愈合率为 83.3%(15/18)。

结论

关节镜下肱二头肌长头肌腱转位术可明显缓解巨大肩袖撕裂患者的疼痛,改善关节活动度,恢复关节功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be20/8996574/805154472266/13018_2022_3121_Fig1_HTML.jpg

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