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中华关节外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (03) : 273 -277. doi: 10.3877/cma.j.issn.1674-134X.2019.03.003

所属专题: 文献

临床论著

关节镜止点重建术治疗中老年肩关节盂唇损伤的初步疗效
张博1, 林源1,(), 王志为1, 任世祥1   
  1. 1. 100020 北京,首都医科大学附属北京朝阳医院骨科
  • 收稿日期:2016-03-24 出版日期:2019-06-01
  • 通信作者: 林源
  • 基金资助:
    北京市医院管理局临床技术创新项目(XMLX201511)

Early clinical results of arthroscopic biceps tendon reconstruction in middle-aged patients with superior labrum anterior posterior tear

Bo Zhang1, Yuan Lin1,(), Zhiwei Wang1, Shixiang Ren1   

  1. 1. Department of Orthopedic, Beijing Chao Yang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2016-03-24 Published:2019-06-01
  • Corresponding author: Yuan Lin
  • About author:
    Corresponding author, Lin Yuan, Email:
引用本文:

张博, 林源, 王志为, 任世祥. 关节镜止点重建术治疗中老年肩关节盂唇损伤的初步疗效[J/OL]. 中华关节外科杂志(电子版), 2019, 13(03): 273-277.

Bo Zhang, Yuan Lin, Zhiwei Wang, Shixiang Ren. Early clinical results of arthroscopic biceps tendon reconstruction in middle-aged patients with superior labrum anterior posterior tear[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2019, 13(03): 273-277.

目的

探讨关节镜下肌腱固定术治疗Ⅱ型肩关节盂唇上部从前到后的损伤(SLAP)的新方法并评价其初步临床疗效。

方法

回顾性分析2012年9月至2015年2月因肩部疼痛于北京朝阳医院骨科行肩关节镜手术的中老年患者共计75例。纳入标准为:年龄大于40岁,保守治疗3个月无效,体格及影像学检查满足Ⅱ型SLAP损伤合并有肩袖损伤的临床诊断;排除标准为:肩关节不稳或曾经行肩部手术的患者,以及因精神系统问题不能配合的患者。记录术前及最后一次随访时患者的美国肩肘外科协会评分(ASES)、加州大学洛杉矶分校评分(UCLA)以及出现不良事件的情况,并采用配对t检验进行术前及术后评分的差异性分析。

结果

最终纳入66例患者(男38例,女28例),平均年龄(56±11)岁,平均随访时间为(17±8)月。患者术前ASES及UCLA评分分别为(62.3±6.6)分、(12.1±2.3)分,最后一次随访时分别为(93.7±4.6)分、(31.3±2.8)分,术后随访结果同术前相比,ASES(t =15.46,P <0.05)及UCLA(t =22.19,P <0.05)评分差异有显著的统计学意义。

结论

利用带线锚钉配合界面螺钉重建二头肌腱止点治疗SLAP损伤合并肩袖损伤的方法安全、可靠,可以降低手术失败率,并获得良好的临床效果。

Objective

To evaluate operative technique and clinical results of arthroscopic biceps tendon reconstruction for the middle-aged patients with superior labrum anterior posterior(SLAP) tear.

Methods

From September 2012 to February 2015, 75 patients with shoulder pain were retrospective analyzed in Beijing Chaoyang hospital. Inclusion criteria: age over 40 years, conservative treatment for three months but invalid, the physical and imaging tests met the clinical diagnosis of typeⅡSLAP injury combined with rotator cuff injury. Exclusion criteria: patients with unstable shoulder or had performed the shoulder surgery before, and the patients who were unable to cooperate due to mental problems. The shoulder function was evaluated according to America Shoulder and Elbow Surgeons (ASES) score and University of California at Los Angeles (UCLA) score, the preoperative and postoperative scores were analyzed by the paired t test using SPSS 19.0 software.

Results

Eventually 66 patients were included with an average age of (56±11) years and with an average follow-up time of (17±8) months. The preoperative ASES score was(62.3±6.6), UCLA score was (12.1±2.3). After the operation, the ASES score was (93.7±4.6)(t=15.46, P<0.05), the UCLA score was (31.3±2.8)(t=22.19, P<0.05). This meant that the arthroscopic biceps tenodesis could improve pain relief.

Conclusion

The method using the suture anchor combine with Bio-Cork screw to construct biceps tendon is safe, reliable, and can reduce the failure rates, and obtain good clinical effect.

图6 术中镜下所见,界面螺钉拧入骨道进行固定,确认肌腱稳定且张力正常
表1 患者术前及末次随访ASES评分、UCLA评分比较 [n=66,(±s)]
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