Jerosch J, Steinbeck J, Strauss J M, Schneider T
Klinik und Poliklinik für Allgenmeine Orthopädie, Westfälischen Wilhelms-Universität Münster.
Unfallchirurg. 1994 Feb;97(2):69-73.
A total of 122 patients with subacromial pathology without tears in the rotator cuff underwent arthroscopic subacromial decompression (ASD) and were re-examined 1-3 years after the operation. All patients' data were recorded before and after operation with reference to a 100-point shoulder score. The group included 12 patients who proved to have an os acromiale on X-ray. Postoperatively scores wee significantly higher (p < 0.05). Patients with os acromiale had a slightly but not significantly worse outcome than the others. Results were excellent in 43% of all patients, good in 17%, and fair in 25%, while 15% were considered failures. Again patients with an os acromiale had a slightly, but not significantly, worse result. Patients with a preoperative pain history of more than 1 year had a significantly worse result than those with a preoperative course of less than 1 year (p < 0.05). This was true for both groups without any differences between them. Older patients also scored worse in both groups. Other factors, e.g. sex, preoperative range of motion, and muscle atrophy, did not significantly influence the result. Our results after ASD in patients with subacromial pathology without rupture of the rotator cuff and with os acromiale are encouraging. Therefore, this minimally invasive procedure seems to be a reasonable alternative to other complex procedures with ORIF in selected cases.
共有122例肩峰下病变且肩袖无撕裂的患者接受了关节镜下肩峰下减压术（ASD），并在术后1至3年进行了复查。所有患者的数据均参照100分的肩部评分在术前和术后进行记录。该组中有12例患者经X线检查证实存在肩峰骨。术后评分显著更高（p < 0.05）。有肩峰骨的患者的结果略差，但差异无统计学意义。所有患者中43%结果为优，17%为良，25%为可，15%被认为手术失败。同样，有肩峰骨的患者结果略差，但差异无统计学意义。术前疼痛病史超过1年的患者的结果明显比术前病程少于1年的患者差（p < 0.05）。两组情况均如此，二者之间无差异。老年患者在两组中的评分也更低。其他因素，如性别、术前活动范围和肌肉萎缩，对结果无显著影响。我们对肩峰下病变、肩袖未破裂且有肩峰骨的患者行ASD后的结果令人鼓舞。因此，在某些特定病例中，这种微创手术似乎是其他复杂的切开复位内固定术的合理替代方案。
