Mormino M A, Gross R M, McCarthy J A
Creighton-Nebraska Health Foundation, Orthopaedic Residency Program, Omaha, USA.
Arthroscopy. 1996 Aug;12(4):457-61. doi: 10.1016/s0749-8063(96)90040-7.
Thirteen patients who developed restrictive subdeltoid adhesions after rotator cuff repair were identified. These patients underwent second-look arthroscopy and takedown of adhesions at an average of 37 weeks after their index surgery. Clinical findings include pain and restricted motion that does not yield to manipulation under anesthesia. Arthroscopic findings are subdeltoid adhesions and a chondral lesion (companion lesion) of the humeral head articular surface. Patients were reevaluated at 26 weeks after their release of adhesions. Prerelease and postrelease University of California, Los Angeles (UCLA) scores average 14.8 and 30.1, respectively. Prerelease and postrelease UCLA pain scores averaged 2.6 and 7.7, respectively. Prerelease and postrelease range of motion was as follows: Flexion, 141/158; abduction, 123/141; internal rotation, 47/69; and external rotation, 53/74. The authors have proposed a theory to explain the clinical and arthroscopic findings in this subgroup of patients who are dissatisfied after rotator cuff repair. A technique for and the results of release of the subdeltoid adhesions also are reported.
确定了13例在肩袖修复术后出现三角肌下粘连受限的患者。这些患者在初次手术后平均37周接受了二次关节镜检查并松解粘连。临床表现包括疼痛和麻醉下手法操作无法缓解的活动受限。关节镜检查发现为三角肌下粘连和肱骨头关节面软骨损伤（伴随损伤）。在粘连松解术后26周对患者进行了重新评估。粘连松解术前和术后加利福尼亚大学洛杉矶分校（UCLA）评分分别平均为14.8分和30.1分。粘连松解术前和术后UCLA疼痛评分分别平均为2.6分和7.7分。粘连松解术前和术后的活动范围如下：前屈，141°/158°；外展，123°/141°；内旋，47°/69°；外旋，53°/74°。作者提出了一种理论来解释这组对肩袖修复术后不满意患者的临床和关节镜检查结果。还报告了三角肌下粘连松解的技术及结果。
