Comparison of Clinical Effects of Double Pulley Combined with Suture Bridge Technique and Double Row Fixation in the Treatment of Full Thickness Rotator Cuff Tears
Department of Joint Surgery,the People's Hospital of Meizhou
摘要目的 研究比较双滑轮结合缝线桥技术和双排固定术治疗肩袖全层撕裂的临床疗效。方法 选取2017年3月至2018年12月在我院治疗的40例肩袖全层撕裂患者为研究对象,采用双滑轮结合缝线桥技术治疗15例,采用双排固定技术治疗25例,比较两组患者一般资料和术前、术后3、6、9个月视觉模拟评分(visual analogue scale,VAS)、Constant-Murley评分、加州大学肩关节评分系统(university of California at LosAngeles,UCLA)、美国肩肘外科协会评分(rating scale of the American shoulder and elbow surgeons,ASES)。结果 本组患者均获随访,随访时间9~12个月,平均14个月。两组患者性别、年龄、撕裂侧别、撕裂原因比较差异无统计学意义(P>0.05);术后3个月两组患者VAS评分比较差异具有统计学意义(P<0.05),而术前、术后6个月、术后9个月VAS评分比较差异无统计学意义(P>0.05);两组患者ConstantMurley评分、UCLA肩关节评分、ASES评分在术前、术后3个月、术后6个月、术后9个月比较差异均无统计学意义(P>0.05);两组患者术后并发症发生率和满意度比较差异均无统计学意义(P>0.05)。结论 关节镜下双滑轮结合缝线桥技术和双排固定术治疗肩袖全层撕裂均可获得较好的肩关节评分,双滑轮结合缝线桥技术较双排固定术治疗肩袖全层撕裂在术后早期疼痛减轻更为明显。
Abstract:Objective To compare of clinical effects of double pulley combined with suture bridge technique and double row fixation in the treatment of full thickness rotator cuff tears.Methods From March 2017 to December 2018,40 cases of patients with full thickness rotator cuff tears were selected.15 cases of patients were treated by double pulley combined with stitch bridge technology,while 25cases of patients were treated by double row fixing technique.The preoperative general data,the VAS score before operation and 3,6 and 9 months after operation,Constant-Murley score,UCLA shoulder joint score,and ASES score of two groups were compared.Results There were no significant differences in gender,age,tear side and tear causes between the two groups(P>0.05).The difference of VAS scores of the two groups at 3 months after surgery were statistically significant(P<0.05).There were no significant differences among VAS scores before sugery,6 months and 9 months after surgery(P>0.05).There were no significant differences in the Constant-Murley score,UCLA shoulder score,and ASES score between the two groups before surgery and 3,6,and 9 months after surgery(P>0.05).There were no significant differences in postoperative complication rate and satisfaction between the two groups(P>0.05).Conclusion Arthroscopic double pulley combined with suture bridge technique and double row fixation for the treatment of rotator cuff tears can obtain better shoulder joint score.Compared with double-row fixation,the doublepulley combined suture bridge technique is more effective in the early postoperative pain relief of rotator cuff tear.
郭伟康,赖兵,黄健,梁传兴,郑锋,刘松浪. 双滑轮结合缝线桥技术和双排固定术治疗肩袖全层撕裂的疗效对比[J]. 实用骨科杂志, 2019, 25(8): 676-680.
Guo Weikang,Lai Bing,Huang Jian,et al. Comparison of Clinical Effects of Double Pulley Combined with Suture Bridge Technique and Double Row Fixation in the Treatment of Full Thickness Rotator Cuff Tears. sygkzz, 2019, 25(8): 676-680.
[1]高绪仁,朱梁,陈永吉,等.关节镜下Suture Bridge双排法和SCOI单排法缝合修复中型肩袖撕裂的疗效比较[J].中国矫形外科杂志,2018,26(22):2107-2110.
[2]许挺,何利雷,王昌兵.肩关节镜下缝线桥技术治疗中度肩袖撕裂的临床疗效观察[J].中国医药科学,2018,8(11):28-31.
[3]Marrero LG,Nelman KR,Nottage WM.Long-term follow-up of arthroscopic rotator cuff repair[J].Arthroscopy,2011,27(7):885-888.
[4]Brady PC,Arrigoni P,Burkhart SS.Evaluation of residual rotatorcuff defects after in vivo single-versus double-row rotator cuff repairs[J].Arthroscopy,2006,22(10):1070-1075.
[5]谭明伟,吴美平.肩关节镜下缝合桥技术修复全层肩袖损伤30例[J].中国中医骨伤科杂志,2018,26(1):59-60.
[6]JVijayvargiya M,Pathak A,Gaur S.Outcome analysis of locking plate fixation in proximal humerus fracture[J].J Clin Diagn Res,2016,10(8):1-5.
[7]Imai T,Gotoh M,Tokunaga T,et al.Cutoff value of Japanese Orthopaedic Association shoulder score in patients with rotator cuff repair:Based on the University of California at Los Angeles shoulder score[J].J Orthop Sci,2017,22(3):438-441.
[8]Werner BC,Chang B,Nguyen JT,et al.What change in American shoulder and elbow surgeons score represents a clinically important change after shoulder arthroplasty[J].Clin Orthop Relat Res,2016,474(12):2672-2681.
[9]孙程,卢翔,马金忠.巨大肩袖撕裂治疗现状[J].中国矫形外科杂志,2017,25(20):1876-1880.
[10]Kummer FJ,Hahn M,Day M,et al.A laboratory comparison of a new arthroscopic transosseous rotator cuff repair to a double row transosseous equivalent rotator cuff repair using suture anchors[J].Bull Hosp Jt Dis,2013,71(2):128-131.
[11]黄宁庆,刘大圣,张斌,等.肩关节镜下单排与双排缝合桥修复技术治疗老年肩袖损伤的效果[J].中国老年学杂志,2018,38(1):163-165.
[12]向明,胡晓川.肩关节镜技术临床应用的进展与思考[J].中国骨伤,2017,30(8):685-688.
[13]黄成校,李刚.关节镜下双滑轮无结缝线桥技术治疗肩袖损伤的效果分析[J].中华骨与关节外科杂志,2018,11(5):375-377.
[14]贾峰.关节镜下双滑轮无结缝线桥固定术与传统缝线桥固定术在肩袖撕裂修复中的效果比较[J].中国当代医药,2018,25(4):89-92.
[15]刘平,敖英芳.关节镜下缝合桥技术与双排缝合技术治疗肩袖部分损伤21例回顾性研究[J].中国运动医学杂志,2016,35(2):137-140.