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基于撕裂位置的关节镜下盂唇撕裂清创术的结果

The results of arthroscopic debridement of glenoid labral tears based on tear location.

作者信息

Payne L Z, Jokl P

机构信息

Department of Orthopaedic Surgery and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut.

出版信息

Arthroscopy. 1993;9(5):560-5. doi: 10.1016/s0749-8063(05)80404-9.

Abstract

A retrospective, average 2-year review of 14 patients with a primary glenoid labral tear treated by arthroscopic debridement was conducted to evaluate the long-term results of labral debridement based on tear location in preoperatively stable shoulders. All patients with concomitant pathology requiring an additional open or arthroscopic procedure were eliminated from this study. Every patient complained of shoulder pain mainly with overhead activities and nine patients (64%) also described "clicking" with shoulder movement. All shoulders were stable to translation in all quadrants during the preoperative examination and examination under anesthesia. The functional results at 6 months' follow-up were 93% excellent or good. However, the results at > 1 year's follow-up (average 2 years) were only 71% excellent or good, with a statistically significant 50% of patients decreased in function. The best results were in the superior and anterior-inferior regions. Three patients with large anterior-superior lesions (60%) developed postoperative instability noted at > 6 months postsurgery, representing a significant difference between groups. One of these patients was able to regain a good functional result with rotator cuff strengthening therapy. Close observation of patients after large anterior-superior labral tear arthroscopic debridement is advised because they are at risk for the delayed onset of instability.

摘要

对14例接受关节镜下清创术治疗的原发性盂唇撕裂患者进行了一项回顾性研究,平均随访2年,以评估在术前稳定的肩关节中,基于撕裂位置的盂唇清创术的长期效果。所有伴有需要额外开放或关节镜手术的合并病变的患者均被排除在本研究之外。每位患者主要在进行过头活动时诉说肩部疼痛,9例患者(64%)还描述了肩部活动时有“咔哒”声。术前检查及麻醉下检查时,所有肩关节在各个象限的平移均稳定。6个月随访时的功能结果为93%为优或良。然而,随访超过1年(平均2年)时,结果仅71%为优或良,50%的患者功能下降具有统计学意义。最佳结果出现在上区和前下区。3例有较大前上病变的患者(60%)在术后6个月以上出现术后不稳定,两组之间存在显著差异。其中1例患者通过加强肩袖治疗恢复了良好的功能结果。建议对前上盂唇撕裂关节镜清创术后的患者进行密切观察,因为他们有延迟出现不稳定的风险。

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