关节镜清理联合富血小板血浆治疗冈上肌钙化性肌腱炎的疗效观察

Effect of arthroscopic debridement combined with platelet rich plasma in treatment of supraspinatus calcified tendinitis

摘要:

目的 探讨关节镜清理联合富血小板血浆（PRP）治疗冈上肌钙化性肌腱炎的临床效果。方法 选取该院采用关节镜清理与PRP治疗冈上肌钙化性肌腱炎的患者46例，分为实验组和对照组，各23例。实验组行肩关节镜下钙化灶清理+PRP注射，对照组行单纯关节镜清理，比较两组的治疗效果。结果 所有患者均得到有效随访。实验组中，5例行肩袖修补术（3例为术前确诊肩袖撕裂，2例为钙化灶较大，清理后行肩袖修补），对照组中，3例行肩袖修补术（2例为术前确诊肩袖撕裂，1例为钙化灶较大，清理后行肩袖修补）。两组患者术后1个月视觉模拟评分法（VAS）明显低于术前，美国肩肘外科协会（ASES）评分明显高于术前，差异均有统计学意义（P < 0.05）。实验组术后1个月VAS明显低于对照组，术后1个月ASES评分明显高于对照组，差异均有统计学意义（t = -5.52，t = 8.73，P = 0.001）。结论 关节镜清理联合PRP治疗冈上肌钙化性肌腱炎，是一种有效、微创的方法。关节镜可以尽量清除钙盐，能对肩袖损伤范围精确评估，并对明确的、损伤较大的肩袖损伤，行带线锚钉肩袖修补。同时，结合PRP注射，可加快损伤肩袖的修复，减轻疼痛，加速肩关节功能康复。

Abstract:

Objective To investigate the clinical efficacy of arthroscopic debridement combined with platelet rich plasma (PRP) in treatment of supraspinatus calcified tendinitis.Methods 23 patients in the experimental group were treated with shoulder arthroscopic calcification clearing with PRP injection, while 23 patients in the control group were treated with simple arthroscopic clearing, and the curative effects were observed and compared.Results All the patients were followed up effectively. Of the 23 cases in the experimental group, 5 cases were treated with rotator cuff repair (3 cases were diagnosed rotator cuff tear before operation, 2 cases were diagnosed with large calcification, and rotator cuff repair was performed after cleaning), and 3 cases were treated with rotator cuff repair (2 cases were diagnosed with rotator cuff tear before operation, 1 case was diagnosed with large calcification, and rotator cuff repair was performed after cleaning). The visual analogue scale (VAS) of the two groups one month after surgery was significantly lower than that before surgery, and the American Association of Shoulder and Elbow Surgeons (ASES) score of the two groups one month after surgery was significantly higher than that before surgery, with statistical significance (P < 0.05). The VAS of the experimental group was significantly lower than that of the control group one month after surgery, and the ASES score was significantly higher than that of the control group one month after surgery, with statistically significant differences（t = -5.52, t = 8.73, P = 0.001）.Conclusion Arthroscopic debridement combined with PRP is an effective and minimally invasive method for the treatment of supraspinatus calcified tendinitis. The calcium salt can be removed as much as possible under arthroscopy, and the scope of rotator cuff injury can be accurately evaluated. For the obvious rotator cuff injury with large damage, the rotator cuff repair with thread anchor nail can be performed. At the same time, combined with PRP, it can accelerate the repair of rotator cuff injury, relieve pain, and accelerate the functional recovery of shoulder joint.