关节镜下改良Mason-Allen与缝线桥技术治疗中小型肩袖撕裂的早期疗效比较

Early effect of arthroscopic modified Mason-Allen and suture-bridge technique for small and medium-size rotator cuff tear

摘要:

目的 比较关节镜下改良Mason-Allen（mMA）与缝线桥技术治疗中小型肩袖撕裂的早期疗效。方法 选取中小型肩袖撕裂患者60例，分为mMA组和缝线桥组，各30例。mMA组采用mMA技术治疗，缝线桥组采用缝线桥技术治疗。比较两组患者手术时间、锚钉数量、术中出血量、肩关节活动度、疼痛视觉模拟评分法（VAS）、美国肩肘外科医师学会（ASES）评分、Constant-Murley评分和再撕裂率。结果 mMA组手术时间短于缝线桥组，术中锚钉使用数量少于缝线桥组，差异均有统计学意义（P < 0.05）；两组患者术中出血量比较，差异无统计学意义（P > 0.05）。术后，两组患者肩关节活动度较术前增大，差异有统计学意义（P < 0.05），两组患者组间肩关节活动度比较，差异无统计学意义（P > 0.05）。术后，两组患者VAS较术前降低，ASES评分和Constant-Murley评分较术前增高，差异均有统计学意义（P < 0.05）；两组患者组间VAS、ASES评分和Constant-Murley评分比较，差异均无统计学意义（P > 0.05）。两组患者再撕裂率比较，差异无统计学意义（P > 0.05）。结论 关节镜下mMA与缝线桥技术治疗中小型肩袖撕裂的早期疗效相当，但mMA的手术时间更短，锚钉使用量更少。

Abstract:

Objective To compare the early effect of arthroscopic modified Mason-Allen (mMA) and suture-bridge technique for small and medium-size rotator cuff tear.Methods 60 patients with small and medium-size rotator cuff tear were divided into mMA group and suture bridge group, 30 cases each. The mMA group was treated with mMA technique, and the suture bridge group was treated with suture-bridge technique. The operative time, the number of anchors used, blood loss, shoulder mobility, pain visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) scale, the Constant-Murley score and the rate of re-tear were compared between the two groups.Results The operative time and the number of anchors used in mMA group were less than those in suture bridge group (P < 0.05), and there was no difference of blood loss between the two groups (P > 0.05). After operation, the shoulder joint motion of two groups was increased compared with before operation (P < 0.05), and there was no statistical difference between the two groups (P > 0.05). After surgery, VAS of the two groups was lower than that before surgery, ASES scale and Constant-Murley scores were higher than those before surgery (P < 0.05), there was no difference in VAS, ASES and Constant-Murley scores between the two groups (P > 0.05). There was no difference in re-tear rate between the two groups (P > 0.05).Conclusion Arthroscopic mMA is similar to suture-bridge technique in the treatment of small and medium-size rotator cuff tear, but operative time of mMA is shorter and it requires less anchors.