Green Clare K, Scanaliato John P, Fares Austin B, Czajkowski Hunter, Dunn John C, Parnes Nata
School of Medicine, The George Washington University, Washington, DC, USA.
Department of Orthopaedic Surgery, William Beaumont Army Medical Center, El Paso, Texas, USA.
Orthop J Sports Med. 2022 May 12;10(5):23259671221095908. doi: 10.1177/23259671221095908. eCollection 2022 May.
Superior labrum from anterior to posterior (SLAP) lesions represent a significant cause of shoulder pain and disability among active duty members of the US military. However, few data exist regarding the surgical management of type VIII SLAP lesions.
We hypothesized that arthroscopic repair would decrease pain and increase function at the midterm follow-up and allow for a high rate of maintenance of active duty status.
Case series; Level of evidence, 4.
Consecutive active duty military patients were identified from January 2011 through June 2015 who underwent arthroscopic repair of type VIII SLAP lesions performed by a single surgeon. Patients were excluded if they underwent glenoid microfracture, other capsulolabral repair, or rotator cuff repair. Outcome measures were completed by patients within 1 week before surgery and at latest follow-up: pain visual analog scale, Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons shoulder score, and Rowe instability score.
A total of 30 patients met the inclusion criteria for the study. The mean ± SD follow-up was 96.60 ± 10.91 months. At final follow-up, the mean visual analog scale score improved from 8.17 ± 1.6 to 1.63 ± 1.90 ( < .0001), the Single Assessment Numeric Evaluation score from 41.65 ± 16.78 to 87.63 ± 13.02 ( < .0001), the American Shoulder and Elbow Surgeons score from 36.47 ± 10.26 to 88.07 ± 13.94 ( < .0001), and the Rowe score from 35.33 ± 6.56 to 90.00 ± 14.68 ( < .0001). Three patients reported postoperative complications, and 1 progressed to further surgery. Overall, 90% of patients remained on active duty military service and were able to return to preinjury levels of work and recreational activity. The failure rate, defined as persistent instability or activity-limiting pain, was 10%.
The results of this study demonstrated favorable outcomes for the majority of patients after arthroscopic repair of type VIII SLAP lesions at midterm follow-up, supporting repair as a viable treatment option for type VIII SLAP tears in this patient population.
从前往后的上盂唇（SLAP）损伤是美国现役军人肩部疼痛和功能障碍的重要原因。然而，关于VIII型SLAP损伤手术治疗的数据很少。
我们假设关节镜修复在中期随访时会减轻疼痛并改善功能，并使较高比例的患者维持现役状态。
病例系列；证据等级，4级。
从2011年1月至2015年6月连续纳入接受同一位外科医生进行VIII型SLAP损伤关节镜修复的现役军人患者。如果患者接受了关节盂微骨折、其他关节囊盂唇修复或肩袖修复，则将其排除。患者在手术前1周内及最新随访时完成以下结果指标：疼痛视觉模拟量表、单项评估数字评分、美国肩肘外科医师学会肩部评分和Rowe不稳定评分。
共有30例患者符合本研究的纳入标准。平均随访时间为96.60±10.91个月。在最终随访时，平均视觉模拟量表评分从8.17±1.6改善至1.63±1.90（P<0.0001），单项评估数字评分从41.65±16.78改善至87.63±13.02（P<0.0001），美国肩肘外科医师学会评分从36.47±10.26改善至88.07±13.94（P<0.0001），Rowe评分从35.33±6.56改善至90.00±14.68（P<0.0001）。3例患者报告了术后并发症，其中1例需要进一步手术。总体而言，90%的患者仍在服现役，并能够恢复到受伤前的工作和娱乐活动水平。定义为持续性不稳定或活动受限性疼痛的失败率为10%。
本研究结果表明，大多数患者在中期随访时接受VIII型SLAP损伤关节镜修复后预后良好，支持将修复作为该患者群体中VIII型SLAP撕裂的可行治疗选择。
