Zheng Hanlin, Liu Yulong, Tu Bizhi, Chen Guang, Ning Rende
Department of Orthopedics, The Third Affiliated Hospital of Anhui Medical University, The First People's Hospital of Hefei), 390 Huaihe Road, Hefei, 230061, Anhui, China.
Sci Rep. 2025 Jan 10;15(1):1563. doi: 10.1038/s41598-025-85925-z.
The aim of this study was to analyze the outcomes of arthroscopic subscapularis tendon repair combined with coracoplasty in the treatment. The study involved 80 patients (46 males, 34 females; aged 33 to 73 years), who underwent arthroscopic repair for subscapularis tears (type I, II, and III) presenting symptoms of anterior shoulder pain and tenderness. Subcoracoid impingement was defined as a coracohumeral distance of less than 6 mm on preoperative magnetic resonance imaging, with a follow-up of was at least two years. The patients were divided into two groups: Group A underwent coracoplasty, while Group B did not. The postoperative functional outcomes of the two groups were compared and analyzed using an independent sample t-test. The patients' prognosis was assessed pre- and postoperatively using the University of California Los Angeles (UCLA) shoulder score, American Shoulder and Elbow Surgeons (ASES) shoulder score, and Visual Analog Scale (VAS)pain score. Postoperatively, primary wound healing was successful in all patients, with no systemic or localized shoulder joint infections or brachial plexus nerve injuries. Both groups showed improvements in overall functional outcomes after surgical intervention. At the 24-month follow-up, all evaluated parameters in both groups demonstrated improvements compared to preoperative values (P < 0.05). The functional scores significantly increased in both groups post-surgery compared to preoperative values (p < 0.01). When comparing the two groups using an independent sample t-test, the p-values for all indicators, except forward flexion range of motion, were below 0.01. The statistical analysis indicated that patients in Group A had better recovery outcomes than those in Group B, except for forward flexion. The results suggested that subcoracoid impingement syndrome could potentially be a significant precursor to subscapularis tendon injuries. It is noteworthy noting that the combined approach of subscapularis tendon repair and coracoplasty showed superior therapeutic efficacy compared to isolated subscapularis tendon repair when subscapularis tendon injuries were associated with subcoracoid impingement.
本研究旨在分析关节镜下肩胛下肌腱修复联合喙突成形术在治疗中的效果。该研究纳入了80例患者(46例男性,34例女性;年龄33至73岁),这些患者因肩胛下肌撕裂(I型、II型和III型)出现前肩部疼痛和压痛症状而接受了关节镜修复。术前磁共振成像显示喙肱距离小于6毫米且随访至少两年被定义为喙突下撞击。患者被分为两组:A组接受喙突成形术,而B组未接受。采用独立样本t检验对两组术后功能结果进行比较和分析。术前和术后使用加州大学洛杉矶分校(UCLA)肩部评分、美国肩肘外科医师学会(ASES)肩部评分和视觉模拟量表(VAS)疼痛评分对患者的预后进行评估。术后,所有患者均实现一期伤口愈合,无全身或局部肩关节感染或臂丛神经损伤。两组在手术干预后总体功能结果均有改善。在24个月随访时,两组所有评估参数与术前值相比均有改善(P < 0.05)。两组术后功能评分与术前值相比均显著提高(p < 0.01)。使用独立样本t检验比较两组时,除前屈活动范围外,所有指标的p值均低于0.01。统计分析表明,除前屈外,A组患者的恢复结果优于B组。结果表明,喙突下撞击综合征可能是肩胛下肌腱损伤的重要先兆。值得注意的是,当肩胛下肌腱损伤与喙突下撞击相关时,肩胛下肌腱修复联合喙突成形术的联合方法显示出比单纯肩胛下肌腱修复更好的治疗效果。