Zhou Y W, Yang Q N, Kang J Y, Chen M J, Wu C C
Department of Joint Surgery, Jinhua Hospital Affiliated to Zhejiang University (Jinhua Central Hospital), Jinhua 321000, China.
Zhonghua Yi Xue Za Zhi. 2024 Aug 27;104(33):3142-3147. doi: 10.3760/cma.j.cn112137-20240126-00206.
To compare the clinical effect of modified anterolateral and traditional acromioplasty in arthroscopic rotator cuff repair. The clinical data of 92 patients with total rotator cuff tears admitted to the Department of Joint Surgery of Jinhua Central Hospital from January 2016 to December 2019 were retrospectively analyzed. Of the patients, 42 were male, 50 were female, with a mean age of (57.1±13.2) years. Among them, 42 patients underwent traditional acromioplasty during arthroscopic rotator cuff repair (traditional group), and 50 underwent modified anterolateral acromioplasty (modified group). The preoperative and postoperative shoulder function of the patients in the two groups were evaluated and compared by using the University of California Los Angeles (UCLA), the rating scale of the American Shoulder and Elbow Surgeons (ASES), and the constant Murley shoulder score scale. And the preoperative and postoperative pain of patients was evaluated with visual analog scale (VAS). The incidence of rotator cuff retears 12 months after operation was counted. There was no statistically significant differences in general information such as gender, age, affected side and course of disease between the two groups before the surgery (all <0.05). All patients were followed up for (12.9±1.1) months. There was no significant differences in the UCLA score (31.4±3.0 vs 32.0±2.5), ASES score (13.1±0.7 vs 13.3±0.6), Constant Murley shoulder score (92.1±6.6 vs 94.3±4.6) and VAS score (1.5±0.8 vs 1.2±1.1) between the traditional group and the modified group 12 months after the operation (all >0.05). The preoperative CSA (36.0°±1.7°) in the traditional group did not differ significantly from that at 12 months postoperatively (35.5°±1.2°) (=0.270); the postoperative CSA at 12 months (30.8°±2.5°) in the modified group was significantly smaller than that before the operation (36.5°±1.9°), and also was smaller than that in the traditional group 12 months after the operation (35.5°±1.2°) (both <0.05). At 12 months after operation, the rate of rotator cuff tears in the traditional group and modified group was 16.7% (7/42) and 4.0% (2/50), respectively (=0.045). Traditional and modified anterolateral acromioplasty in treating total rotator cuff tears using arthroscopic rotator cuff repair can significantly improve shoulder joint function. However, modified anterolateral acromioplasty significantly reduces the CSA value and decreases the incidence of rotator cuff re-tears.
比较改良前外侧肩峰成形术与传统肩峰成形术在关节镜下肩袖修复中的临床效果。回顾性分析2016年1月至2019年12月金华市中心医院关节外科收治的92例全层肩袖撕裂患者的临床资料。其中男性42例，女性50例，平均年龄（57.1±13.2）岁。其中42例患者在关节镜下肩袖修复术中采用传统肩峰成形术（传统组），50例采用改良前外侧肩峰成形术（改良组）。采用美国加州大学洛杉矶分校（UCLA）评分、美国肩肘外科医师协会（ASES）评分量表及Constant Murley肩关节评分量表对两组患者术前、术后肩关节功能进行评估比较。采用视觉模拟评分法（VAS）评估患者术前、术后疼痛情况。统计术后12个月肩袖再撕裂发生率。两组患者术前性别、年龄、患侧及病程等一般资料比较，差异均无统计学意义（均P<0.05）。所有患者均获随访（12.9±1.1）个月。术后12个月，传统组与改良组UCLA评分（31.4±3.0 vs 32.0±2.5）、ASES评分（13.1±0.7 vs 13.3±0.6）、Constant Murley肩关节评分（92.1±6.6 vs 94.3±4.6）及VAS评分（1.5±0.8 vs 1.2±1.1）比较，差异均无统计学意义（均P>0.05）。传统组术前肩峰下夹角（CSA）为（36.0°±1.7°），术后12个月为（35.5°±1.2°），差异无统计学意义（P=0.270）；改良组术后12个月CSA为（30.8°±2.5°），明显小于术前（36.5°±1.9°），且小于传统组术后12个月（35.5°±1.2°），差异均有统计学意义（均P<0.05）。术后12个月，传统组肩袖再撕裂率为16.7%（7/42），改良组为4.0%（2/50），差异有统计学意义（P=0.045）。传统肩峰成形术与改良前外侧肩峰成形术在关节镜下肩袖修复治疗全层肩袖撕裂中均能显著改善肩关节功能。然而，改良前外侧肩峰成形术能显著降低CSA值，减少肩袖再撕裂发生率。
