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关节镜下修复 II 型 SLAP 损伤的长期疗效:重返术前运动水平评估及并发症的关键危险因素。

Long-term results of arthroscopic repair of type II SLAP lesions in sports: assessment of return to pre-injury playing level and critical risk factors for complication.

机构信息

Orthopaedic Department, Pineta Grande Hospital Castel Volturno, Caserta, Italy.

Dipartimento di Scienze Mediche e Chirurgiche Avanzate, Università Degli Studi Della Campania, "Luigi Vanvitelli", Naples, Italy.

出版信息

Eur J Orthop Surg Traumatol. 2024 Jan;34(1):433-440. doi: 10.1007/s00590-023-03677-w. Epub 2023 Aug 13.

Abstract

PURPOSE

The management of isolated SLAP lesions is still debated especially in athletes. Aims of the study were: 1. to analyse our algorithm to treat SLAP lesions starting from the selection of patients for surgery and 2. to correlate the familiarity for diabetes and hypothyroid disorders with post-operative results.

METHODS

Seventy-eight patients with isolated SLAP lesion were arthroscopically treated using knotless anchors and microfractures. All patients had a pre-operative and post-operative clinical examination according to Walch-Duplay, Constant, Rowe and Dash scores and interviewed for familiarity to diabetes and hypothyroid disorders.

RESULTS

About 68.8% of patients solved pain with rehabilitation. About 29% of patients returned to the sports activities. About 32% of patients were no responder to physiotherapy and were arthroscopically treated. About 53.9% of patients responded excellent, 34.7% good, 3.8% medium and 7.6% poor results according to Walch-Duplay score. The Constant score increased from 64 to 95, the Rowe score from 48 to 96. The outcomes were significantly worse in patients with familiarity for diabetes.

CONCLUSIONS

Microfractures and knotless anchor give long-term good results for the treatment of SLAP lesions in athletes. The familiarity for diabetes is an important risk factor that can lead to decreased outcomes.

摘要

目的

孤立性 SLAP 损伤的治疗仍存在争议,尤其是在运动员中。本研究的目的是:1. 分析我们从手术患者选择开始治疗 SLAP 损伤的算法;2. 分析糖尿病和甲状腺功能减退症的发病情况与术后结果的相关性。

方法

78 例孤立性 SLAP 损伤患者采用无结锚钉和微骨折技术进行关节镜治疗。所有患者均进行术前和术后临床检查(Walch-Duplay、Constant、Rowe 和 Dash 评分),并对糖尿病和甲状腺功能减退症的发病情况进行问卷调查。

结果

约 68.8%的患者通过康复治疗解决了疼痛问题。约 29%的患者恢复了运动活动。约 32%的患者对物理治疗无反应,需要进行关节镜治疗。根据 Walch-Duplay 评分,约 53.9%的患者结果为优,34.7%为良,3.8%为中,7.6%为差。Constant 评分从 64 分增加到 95 分,Rowe 评分从 48 分增加到 96 分。糖尿病发病的患者结局明显较差。

结论

微骨折和无结锚钉治疗运动员的 SLAP 损伤可获得长期良好的结果。糖尿病的发病是一个重要的危险因素,可导致结局较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9fb/10771416/c51ec8d2b779/590_2023_3677_Fig1_HTML.jpg

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