关节镜下三联松解术联合肩袖修补术治疗肩袖损伤合并肩周炎的疗效
Outcome of arthroscopic triple release combined with rotator cuff repair in the treatment of rotator cuff injury combined with frozen shoulder.
作者信息
Hu Jieliang, Wei Kongxing, Xu Yinping, Chen Liyuan
机构信息
Jieliang Hu, Second Department of Orthopedics, The Third Affiliated Hospital of Gansu University of Traditional, Chinese Medicine (Baiyin City First People's Hospital), Baiyin 730900, Gansu, China.
Kongxing Wei, Second Department of Orthopedics, The Third Affiliated Hospital of Gansu University of Traditional, Chinese Medicine (Baiyin City First People's Hospital), Baiyin 730900, Gansu, China.
出版信息
Pak J Med Sci. 2024 Jan-Feb;40(3Part-II):520-525. doi: 10.12669/pjms.40.3.7709.
OBJECTIVE
To investigate the effect of arthroscopic triple release combined with rotator cuff repair in the treatment of rotator cuff injury combined with frozen shoulder and its influence on the range of motion and pain score of shoulder joint, and the levels of serum pain mediators.
METHODS
This was prospective study. A total of 132 patients with rotator cuff injury combined with frozen shoulder admitted to The Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from December 2020 to December 2022 were prospectively selected and divided into two groups according to the random number table method: control group (n=67) and observation group (n=65). Patients in the control group were treated with arthroscopic rotator cuff repair alone, while those in the observation group were treated with arthroscopic triple release combined with rotator cuff repair, and the surgical effects of the two groups were compared.
RESULTS
Three months after treatment, the external rotation, internal rotation, abduction, forward flexion, β-endorphin(β-EP), prostagranin E2 (PGE2) and substance P(SP)in the observation group were better than those in the control group (P<0.05), while the weight-bearing strength of the affected limb in internal rotation, external rotation and forward flexion was higher than that of the control group(P<0.05). Meanwhile, the Visual Analogue Scale (VAS) score of the observation group was lower than that of the control group at one month and three months after treatment, while the University of California at Los Angeles shoulder rating scale (UCLA) score and Constant-Murley Score (CMS) were higher than those of the control group (P< 0.05).
CONCLUSION
Arthroscopic triple release combined with rotator cuff repair improves various effects for patients with rotator cuff injury combined with frozen shoulder, such as ameliorating the muscle strength of the affected limb and improving the level of pain mediators.
目的
探讨关节镜下三联松解联合肩袖修复术治疗肩袖损伤合并肩周炎的效果及其对肩关节活动范围、疼痛评分和血清疼痛介质水平的影响。
方法
本研究为前瞻性研究。前瞻性选取2020年12月至2022年12月在甘肃中医药大学第三附属医院收治的132例肩袖损伤合并肩周炎患者，根据随机数字表法分为两组：对照组（n = 67）和观察组（n = 65）。对照组患者仅接受关节镜下肩袖修复术治疗，观察组患者接受关节镜下三联松解联合肩袖修复术治疗，比较两组的手术效果。
结果
治疗3个月后，观察组的外旋、内旋、外展、前屈、β-内啡肽（β-EP）、前列腺素E2（PGE2）和P物质（SP）均优于对照组（P < 0.05），患侧肢体在内旋、外旋和前屈时的负重力量高于对照组（P < 0.05）。同时，观察组在治疗后1个月和3个月时的视觉模拟评分（VAS）低于对照组，而加州大学洛杉矶分校肩关节评分量表（UCLA）评分和Constant-Murley评分（CMS）高于对照组（P < 0.05）。
结论
关节镜下三联松解联合肩袖修复术对肩袖损伤合并肩周炎患者具有多种改善效果，如改善患侧肢体肌力、提高疼痛介质水平。
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