Sachs R A, Stone M L, Devine S
Department of Orthopedic Surgery, Kaiser Hospital, San Diego, CA 92120.
Arthroscopy. 1994 Jun;10(3):248-54. doi: 10.1016/s0749-8063(05)80106-9.
Between May 1988 and May 1990, 44 patients with Stage II impingement were randomized into open and arthroscopic treatment groups. Forty-one patients were available for final follow-up in May 1991: 22 in the open group, 19 in the arthroscopic group. Comparisons of pain, function, motion, and strength were made preoperatively and at 2, 6, 12, 26, and 52 weeks postoperatively. Final analysis showed that the main benefits of arthroscopic acromioplasty were evident in the first 3 months postoperatively. Arthroscopic patients regained flexion and strength more rapidly than did open patients, had shorter hospitalizations, used less narcotics, and returned more quickly to both work and activities of daily living. By 3 months postoperatively, open patients tended to "catch up" with arthroscopic patients, and further recovery was equivalent. In both groups, full recovery took at least 1 year for the majority of patients and in both groups at 1 year > 90% of patients achieved a satisfactory result. Because of its medical and economic advantages for both the patient and the health-care system, we conclude that arthroscopic acromioplasty should become the procedure of choice for patients with impingement syndrome refractory to conservative treatment.
在1988年5月至1990年5月期间，44例II期撞击综合征患者被随机分为开放手术组和关节镜手术组。1991年5月有41例患者可供最终随访：开放手术组22例，关节镜手术组19例。在术前以及术后2周、6周、12周、26周和52周对疼痛、功能、活动度和力量进行了比较。最终分析表明，关节镜下肩峰成形术的主要益处在术后前3个月最为明显。接受关节镜手术的患者比接受开放手术的患者更快地恢复了屈曲和力量，住院时间更短，使用的麻醉剂更少，并且更快地恢复了工作和日常生活活动。到术后3个月时，接受开放手术的患者往往会“赶上”接受关节镜手术的患者，并且进一步的恢复情况相当。在两组中，大多数患者至少需要1年才能完全恢复，并且在1年时两组中超过90%的患者都取得了满意的结果。由于关节镜下肩峰成形术对患者和医疗保健系统都具有医学和经济优势，我们得出结论，对于保守治疗无效的撞击综合征患者，关节镜下肩峰成形术应成为首选的治疗方法。
