探讨肩关节下南加州骨科研究所单排缝合技术(SCOI row)治疗大中型肩袖撕裂的疗效。

对2018年6月至2018年8月南方医科大学第五附属医院关节外科使用SCOI row技术缝合治疗的大中型肩袖撕裂患者进行回顾性研究。纳入中型或者大型肩袖撕裂，排除依从性较差合并其他损伤的患者，共纳入26例患者，男10例，女16例；平均年龄(64±5)岁。SCOI row技术即采用单排3线锚钉固定结合足印区周围扩多个骨髓孔技术。术前关节镜下测量肩袖撕裂范围为2～4 cm，其中冈上肌撕裂9例(34.6%)，冈上肌、肩胛下肌撕裂11例(42.4%)，冈上肌、冈下肌、肩胛下肌撕裂3例(11.5%)，冈上肌、冈下肌撕裂3例(11.5%)。术后6个月通过MRI评判肩袖是否愈合，测量足印区新组织厚度，比较术前与术后6个月疼痛视觉模拟评分(VAS)及肩关节功能评分(UCLA)及肩关节主、被动活动度。术前与术后6个月的数据比较采用配对t检验。

所有患者术后获(7.9±1.6)个月随访。术前、术后6个月VAS评分分别为(6.5±1.7)、(2.1±0.8)分，差异有统计学意义(t ＝10.225，P<0.05)。UCLA评分术前为(12.7±3.8)、术后6个月(31.1±1.6)分，差异有统计学意义(t ＝-3.066, P<0.05)。术后6个月足印区新组织厚度平均为(7.08±0.28)mm。术后6个月患者被动前屈、主动前屈、被动外展、主动外展、中立位被动外旋、中立位主动外旋活动度分别为(162.1±10.5)°、(155.3±38.5)°、(138.2±29.3)°、(130.4±22.4)°、(26.2±8.2)°、(15.3±7.3)°，均较术前明显提高(t ＝-7.913、-11.263、-8.286、-7.285、-11.734、-4.891，均为P <0.05)。术后6个月MRI显示肩袖撕裂足印区完全愈合为24例，再次撕裂2例，愈合率92.3%。

SCOI row技术缝合肩袖撕裂通过MRI评判愈合较高，肩关节功能恢复较好，疼痛缓解，是一种治疗肩袖撕裂的有效方法。

To investigate the efficacy of Southern California Orthopedic Institute single row suturing technique(SCOI Row) in the treatment of medium and large rotator cuff tears.

A retrospective study was conducted in the patients with large and medium-sized rotator cuff tears treated with SCOI Row suture in the joint surgery department of the fifth affiliated hospital of Southern Medical University from June 2018 to August 2018. Medium or large rotator cuff tears were included, and the patients with poor compliance and other injuries were excluded. A total of 26 patients were enrolled, including 10 males and 16 females. The average age was (64±5) years. SCOI ROW technology adopts single row three-line anchor fixation combined with multiple bone marrow pore enlargement around the footprint area. The range of rotator cuff tear measured under preoperative arthroscopy was from two to four centimeters, including supraspinatus tear in nine cases (34.6%), supraspinatus and subscapularis muscle tear in 11 cases (42.4%), supraspinatus, subspascularis muscle tear in three cases (11.5%), supraspinatus and subscapularis muscle tear in three cases (11.5%), supraspinatus and subscapularis muscle tear in three cases (11.5%). Six months after the operation, the rotator cuff healing was evaluated by MRI, the new tissue thickness in the foot print area was measured, and the pain visual analogue scale (VAS), shoulder joint function score (UCLA), and shoulder joint active and passive activity were statistically compared before and six months after the operation. Paired t-test was used to compare data before and six months after surgery.

All the patients were followed up for six to 10 months (7.9±1.6). Before and six months after the surgery, VAS scores were (6.5±1.7) and (2.1±0.8), UCLA scores were (12.7±3.8) and (31.1±1.6). The differences were statistically significant (VAS t=10.225, UCLA t=-3.066, both P <0.05). The average new tissue thickness in the foot print area six months after the operation was (7.08±0.28) mm. At six months after the operation, the activity levels of passive pronation, active pronation, passive abduction, active abduction, passive pronation in the neutral position and active pronation in the neutral position were(162.1±10.5)°, (155.3±38.5)°, (138.2±29.3)°, (130.4±22.4)°, (26.2±8.2)°, (15.3±7.3)°, respectively, which were significantly higher than those before the operation, and the differences were statistically significant (t =-7.913, - 11.263, -8.286, -7.285, -11.734, -4.891, all P <0.05). Six months after the operation, MRI showed that the rotator cuff tear completely healed in 24 cases, and tore again in two cases, with a healing rate of 92.3%.

The rotator cuff tear with SCOI row technique is an effective treatment option with good healing rate, pain relief and it is beneficial for the shoulder function.