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关节镜肩袖修复术中预防性肱二头肌长头腱切断术并不减少术后僵硬:一项回顾性对比研究。

Preemptive middle glenohumeral ligament release in arthroscopic rotator cuff repair does not reduce the postoperative stiffness: a retrospective comparative study.

机构信息

Department of Orthopaedic Surgery, Ichinomiya Nishi Hospital, 1Jihira, Ichinomiya City, 494-0001, Kaimei, Aichi, Japan.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, 734-8551, Hiroshima, Japan.

出版信息

BMC Musculoskelet Disord. 2023 Jun 15;24(1):490. doi: 10.1186/s12891-023-06611-7.

Abstract

BACKGROUND

This study aimed to evaluate the efficacy of preemptive middle glenohumeral ligament (MGHL) release in arthroscopic rotator cuff repair (ARCR) to reduce postoperative stiffness.

METHODS

Patients who underwent ARCR were enrolled and allocated into two groups retrospectively: the preemptive MGHL release group (n = 44) and the preemptive MGHL non-release group (n = 42). Clinical outcomes were assessed and compared between the two groups, including the range of motion, Japanese Orthopedic Association Shoulder Score, Constant Shoulder Score, and the University of California, Los Angeles Score preoperatively and 3 months, 6 months, and 12 months postoperatively and complications. The integrity of the repaired tendon was assessed at the 12-month follow-up using magnetic resonance imaging.

RESULTS

There were no significant differences between the groups in all range of motion and all functional scores at any of the assessed time points. There was also no significant difference in the healing failure rate 2.3% in the preemptive MGHL group and 2.4% in the preemptive MGHL non-release group (p = .97), and postoperative stiffness was 2.3% in the preemptive MGHL group and 7.1% in the preemptive MGHL non-release group (p = .28). There was no postoperative instability in both group.

CONCLUSION

ARCR effectively facilitates the recovery of range of motion and function in patients with a rotator cuff tear. However, preemptive MGHL release could not be an effective method to reduce postoperative stiffness.

摘要

背景

本研究旨在评估关节镜肩袖修复术(ARCR)中预防性松解盂肱中韧带(MGHL)以减少术后僵硬的疗效。

方法

回顾性纳入并分为两组接受 ARCR 的患者:预防性 MGHL 松解组(n=44)和预防性 MGHL 未松解组(n=42)。评估并比较两组之间的临床结果,包括术前和术后 3 个月、6 个月和 12 个月的活动范围、日本骨科协会肩关节评分、Constant 肩关节评分和加利福尼亚大学洛杉矶分校评分以及并发症。在 12 个月的随访中,使用磁共振成像评估修复肌腱的完整性。

结果

在任何评估时间点,两组在所有活动范围和所有功能评分方面均无显著差异。在预防性 MGHL 组和预防性 MGHL 未松解组中,愈合失败率(2.3%和 2.4%)(p=0.97)和术后僵硬率(2.3%和 7.1%)(p=0.28)也无显著差异。两组均无术后不稳定。

结论

ARCR 可有效促进肩袖撕裂患者活动范围和功能的恢复。然而,预防性松解 MGHL 并不能有效减少术后僵硬。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74da/10268456/977c4b4a286f/12891_2023_6611_Fig1_HTML.jpg

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