关节镜下双锁环缝合技术对中小型肩袖撕裂患者肩关节功能的影响

Effect of arthroscopic double locking ring suture technique on shoulder joint function in small and medium-sized patients with rotator cuff tear

摘要:

目的 探讨关节镜下双锁环缝合技术对中小型肩袖撕裂患者肩关节功能的影响。方法 选取2020年1月－2022年6月该院收治的中小型肩袖撕裂患者54例，使用随机数表法分为对照组和治疗组，每组27例。对照组予以常规单排改良Mason-Allen技术，治疗组予以关节镜下双锁环缝合技术。比较两组患者手术时间、术中出血量、住院总时间、术后6个月的临床疗效和复发率。比较不同时间点疼痛情况、肩关节外展活动度、术前和术后3个月美国加州大学洛杉矶分校（UCLA）评分、美国肩肘外科协会（ASES）评分和Constant-Murley评分，以及随访6个月期间关节僵直发生率。结果 治疗组手术时间明显短于对照组，差异有统计学意义（P < 0.05）；术后随访6个月，治疗组优良率明显高于对照组，差异有统计学意义（P < 0.05）；术后1、3和6个月，两组患者疼痛视觉模拟评分法（VAS）评分较术前降低，且治疗组低于对照组，差异均有统计学意义（P < 0.05）；术后3个月，两组患者UCLA评分、ASES评分和Constant-Murley评分较术前升高，且治疗组高于对照组，差异均有统计学意义（P < 0.05）；术后1、3和6个月，两组患者肩关节外展活动度较术前增大，差异均有统计学意义（P < 0.05）；随访6个月期间，治疗组关节僵直发生率为3.70%，明显低于对照组的29.63%，差异有统计学意义（P < 0.05）；术后随访6个月，治疗组复发率为0.00%，明显低于对照组的18.52%，差异有统计学意义（P < 0.05）。结论 中小型肩袖撕裂患者采用关节镜下双锁环缝合技术进行治疗，可缩短手术时间，有效地缓解患者疼痛，改善肩关节活动度，恢复肩关节功能，还能降低关节僵直发生率和复发率，提高临床疗效。

Abstract:

Objective To explore the effect of arthroscopic double locking ring suture technique on shoulder joint function in small and medium-sized patients with rotator cuff tear.Methods From January 2020 to June 2022, 54 small and medium-sized patients with rotator cuff tear were selected and randomly divided into control group and treatment group with 27 cases in each group. The control group was repaired by conventional single-row modified Mason-Allen technique, while the treatment group was repaired by arthroscopic double locking ring suture technique. The operation time, blood loss, total hospitalization time, the clinical efficacy and recurrence rate 6 months after operation of the two groups were compared. The pain at different time points, abduction of shoulder joint, University of California at Los Angeles (UCLA) scale, American Shoulder and Elbow Surgeons (ASES) scale and Constant-Murley scale before and 3 months after operation were compared. The incidence of joint stiffness was followed up for 6 months.Results The operation time in the treatment group was significantly shorter than that in the control group, with statistical significance (P < 0.05). After 6 months' follow-up, the total excellent and good rate in the treatment group was significantly higher than that in the control group, with statistical significance (P < 0.05). At the 1, 3 and 6 months after operation, the visual analogue scale (VAS) of the two groups decreased compared with that before operation, and the treatment group was lower than that of the control group, with statistical significance (P < 0.05). Three months after operation, the UCLA scale, ASES scale and Constant-Murley scale of the two groups were higher than those before operation, and the treatment group was higher than that of the control group, and the differences were statistically significant (P < 0.05). At the 1, 3 and 6 months after operation, the abduction range of the patients in the two groups increased compared with that before operation, and the differences were statistically significant (P < 0.05). During the follow-up of 6 months, the incidence of joint stiffness in the treatment group was 3.70%, which was significantly lower than that in the control group (29.63%), and the differences were statistically significant (P < 0.05). After 6 months' follow-up, the recurrence rate in the treatment group was 0.00%, which was significantly lower than that in the control group (18.52%), with statistical significance (P < 0.05).Conclusion Small and medium-sized patients with rotator cuff tears can be treated by arthroscopic double locking ring suture technology, which can shorten the operation time, effectively relieve the pain of patients, improve shoulder joint mobility, improve shoulder joint function, reduce the incidence and recurrence rate of joint stiffness, and improve clinical efficacy.