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关节镜下治疗盂唇撕裂。

Arthroscopic treatment of glenoid labral tears.

作者信息

Cordasco F A, Steinmann S, Flatow E L, Bigliani L U

机构信息

Shoulder Service, New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, New York.

出版信息

Am J Sports Med. 1993 May-Jun;21(3):425-30; discussion 430-1. doi: 10.1177/036354659302100317.

Abstract

We reviewed 52 consecutive patients who had undergone arthroscopic labral debridement. The average age was 29 and there were 35 men and 17 women. At operation, 27 patients had superior labrum anterior and posterior (SLAP) lesions, 20 patients had anteroinferior labral lesions, and 5 patients had posterior labral lesions. Despite the fact that, preoperatively, none of these patients had a history of dislocations or clinically evident instability, 70% of the patients with superior labral lesions, and all of those with anteroinferior and posterior lesions had instability on examination under anesthesia. The average followup was 36 months. At 1 year after arthroscopy, 78% of the patients with superior lesions had excellent relief compared with 30% of the patients in the anteroinferior group. At 2 years followup, these results decreased to 63% and 25%, respectively, and only 45% of the patients with superior labral lesions and 25% of those with anteroinferior lesions had returned to their previous athletic performance level. Four patients required a reoperation: 2 for instability and 2 for impingement. We conclude that occult instability is frequently present in patients with glenoid labral tears. The overall results are not encouraging, but this procedure may have an indication for short-term goals in competitive athletes or those who are willing to accept some compromise in function.

摘要

我们回顾了52例连续接受关节镜下盂唇清创术的患者。平均年龄为29岁,其中男性35例,女性17例。手术时,27例患者存在上盂唇前后(SLAP)损伤,20例患者存在前下盂唇损伤,5例患者存在后盂唇损伤。尽管这些患者术前均无脱位病史或临床上明显的不稳定情况,但70%的上盂唇损伤患者以及所有前下和后盂唇损伤患者在麻醉下检查时存在不稳定。平均随访时间为36个月。关节镜检查后1年,78%的上盂唇损伤患者症状得到明显缓解,而前下盂唇损伤组患者的这一比例为30%。随访2年时,这些结果分别降至63%和25%,只有45%的上盂唇损伤患者和25%的前下盂唇损伤患者恢复到了之前的运动表现水平。4例患者需要再次手术:2例因不稳定,2例因撞击。我们得出结论,盂唇撕裂患者常存在隐匿性不稳定。总体结果并不令人鼓舞,但该手术对于竞技运动员或那些愿意接受一定功能妥协的患者的短期目标可能有适应证。

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