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两种手术方法治疗肩周炎的比较

A comparison of two surgical methods in the treatment of shoulder adhesive capsulitis.

作者信息

Ari B, Altunkiliç T

机构信息

Department of Orthopedics and Traumatology, Faculty of Medicine, Malatya Turgut Ozal University, Hasircilar, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Jan;27(2):467-475. doi: 10.26355/eurrev_202301_31046.

Abstract

OBJECTIVE

The purpose of the study was to compare the outcomes of arthroscopic capsular release surgery and manipulation of patients with resistant primary adhesive capsulitis (AC) under anesthesia.

PATIENTS AND METHODS

The study comprised forty-four patients who had surgery after being given a diagnosis of primary AC. Patients who had both passive and active glenohumeral and scapulothoracic movements equal to or less than 100° elevation and less than 50% of external rotation compared to the contralateral side were considered to have resistant adhesive capsulitis and were included in the study. Conservative treatments such as intra-articular steroid injections and physical therapy had failed to relieve the pain in these patients for at least six months. The patients who took part in the trial underwent manipulation under anesthesia (group 1) and arthroscopic capsular release (group 2) operations. The chosen surgical procedure was chosen at random and based on the surgeon's preferences. examining the patients' demographic information. After treatment, the patients were examined at three-month, six-month, and one-year intervals. Joint range of motion, visual analogue scale (VAS), and Constant-Murley shoulder scores were all recorded. Statistics were used to compare the outcomes of the two surgical techniques in this study both before and after the procedure.

RESULTS

The study's participants' gender, side, extra procedure, and age factors did not show a statistically significant difference between groups 1 and 2 (p<0.05). According to the age, gender, side, additional process, and homogeneous distribution throughout the groups. No statistically significant difference was discovered between groups 1 and 2 in any of the measurements taken from study participants during the follow-up period: Pre-op visual pain scores (VPS), Post-op 3rd month VPS, Post-op 1st year VPS, Pre-op Constant score, Post-op 6th month Constant score, and Post-op 1st year Constant score (p<0.05). The change in VPS and Constant Score values over time did not show a statistically significant difference between the groups (p<0.05). A statistically significant difference between the groups was discovered in each of the Pre-op period and Post-op 6th month VPS assessments (p<0.05).

CONCLUSIONS

Although there was no statistically significant difference between the two studied therapies, the surgical method was shown to be more beneficial in both groups the shorter the pre-op period was between the onset of the complaints and the operation.

摘要

目的

本研究的目的是比较关节镜下关节囊松解手术与麻醉下手法治疗原发性粘连性肩周炎(AC)患者的疗效。

患者与方法

本研究纳入了44例被诊断为原发性AC后接受手术的患者。与对侧相比,被动和主动的盂肱关节及肩胛胸壁关节活动度在抬高时等于或小于100°且外旋小于50%的患者被认为患有难治性粘连性肩周炎,并被纳入本研究。关节内注射类固醇和物理治疗等保守治疗未能使这些患者的疼痛缓解至少6个月。参与试验的患者接受了麻醉下手法治疗(第1组)和关节镜下关节囊松解术(第2组)。所选的手术方法是随机选择的,并基于外科医生的偏好。检查患者的人口统计学信息。治疗后,每隔三个月、六个月和一年对患者进行检查。记录关节活动范围、视觉模拟量表(VAS)和Constant-Murley肩关节评分。本研究使用统计学方法比较两种手术技术在术前和术后的疗效。

结果

研究参与者的性别、患侧、额外手术及年龄因素在第1组和第2组之间未显示出统计学上的显著差异(p<0.05)。根据年龄、性别、患侧、额外手术情况,各组分布均匀。在随访期间对研究参与者进行的任何测量中,第1组和第2组之间均未发现统计学上的显著差异:术前视觉疼痛评分(VPS)、术后第3个月VPS、术后第1年VPS、术前Constant评分、术后第6个月Constant评分和术后第1年Constant评分(p<0.05)。两组间VPS和Constant评分值随时间的变化未显示出统计学上的显著差异(p<0.05)。在术前和术后第6个月VPS评估中,两组间均发现了统计学上的显著差异(p<0.05)。

结论

虽然两种研究治疗方法之间没有统计学上的显著差异,但研究表明,对于两组患者,从出现症状到手术的术前时间越短,手术方法越有益。

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