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-  2015 

关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损

DOI: doi:10.7507/1002-1892.20150145

Keywords: 巨大肩袖损伤, 肱二头肌长头腱, 肌腱病, 关节镜, 肌腱联合固定术

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Abstract:

目的探讨关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损的的疗效。 方法回顾分析2011年1月-2013年6月,采用关节镜下肌腱联合固定术治疗的48例巨大肩袖损伤伴肱二头肌长头腱近端病损患者临床资料。男22例,女26例;年龄35~59岁,平均46岁。存在明确创伤史者12例。病程1~57个月,平均4.6个月。患肩中重度疼痛,关节活动范围及肌力较健侧下降。根据Goutallier分型标准:0级3例,1级18例,2级27例。记录手术时间以及相关并发症发生情况。采用疼痛视觉模拟评分(VAS)、肩关节活动范围、前屈上举及屈肘力量、Constant-Murley肩关节功能评分、加州大学洛杉矶分校(UCLA)评分、美国肩肘外科医师(ASES)评分、Mayo肘关节功能评分(MEPS)以及MRI复查评价疗效。 结果患者均顺利完成手术,手术时间120~160 min,平均135 min。术后切口均Ⅰ期愈合。1例术后出现肩关节肿胀、切口渗血,经对症处理后愈合。48例患者均获随访,随访时间12~18个月,平均13.9个月。术后6个月复查MRI示肌腱愈合良好。与术前相比,术后12个月VAS评分显著降低,肩关节前屈上举、外旋、体侧内旋以及前屈上举肌力均增加,ASES评分、Constant-Murley评分及UCLA评分亦上升,差异均有统计学意义(P<0.05);而肘关节MEPS评分及屈肘肌力与术前比较,差异无统计学意义(P>0.05)。 结论关节镜下肌腱联合固定术治疗巨大肩袖损伤伴肱二头肌长头腱近端病损,可获得满意疗效

References

[1]  10. Ide J, Tokiyoshi A, Hirose J, et al. Arthroscopic repair of traumatic combined rotator cuff tears involving the subscapularis tendon. J Bone Joint Surg (Am), 2007, 89(11):2378-2388.
[2]  11. Namdari S, Henn RF 3rd, Green A. Traumatic anterosuperior rotator cuff tears:the outcome of open surgical repair. J Bone Joint Surg (Am), 2008, 90(9):1906-1913.
[3]  13. Chen CH, Chen CH, Chang CH, et al. Classification and analysis of pathology of the long head of the biceps tendon in complete rotator cuff tears. Chang Gung Med J, 2012, 35(3):263-270.
[4]  15. Karataglis D, Papadopoulos P, Boutsiadis A, et al. Ultrasound evaluation of the distal migration of the long head of biceps tendon following tenotomy in patients undergoing arthroscopic repair of tears of the rotator cuff. J Bone Joint Surg (Br), 2012, 94(11):1534-1539.
[5]  17. Kelly AM, Drakos MC, Fealy S, et al. Arthroscopic release of the long head of the biceps tendon:functional outcome and clinical results. Am J Sports Med, 2005, 33(2):208-213.
[6]  18. Koh KH, Ahn JH, Kim SM, et al. Treatment of biceps tendon lesions in the setting of rotator cuff tears:prospective cohort study of tenotomy versus tenodesis. Am J Sports Med, 2010, 38(8):1584-1590.
[7]  19. Mazzocca AD, Bicos J, Santangelo S, et al. The biomechanical evaluation of four fixation techniques for proximal biceps tenodesis. Arthroscopy, 2005, 21(11):1296-1306.
[8]  20. Friedman DJ, Dunn JC, Higgins LD, et al. Proximal biceps tendon:injuries and management. Sports Med Arthrosc, 2008, 16(3):162-169.
[9]  21. Habermeyer P, Magosch P, Pritsch MT, et al. Anterosuperior impingement of the shoulder as a result of pulley lesions:a prospective arthroscopic study. J Shoulder Elbow Surg, 2004, 13(1):5-12.
[10]  1. 鲁谊, 朱以明, 姜春岩. 肌腱联合固定术治疗巨大肩袖损伤合并肱二头肌长头腱病变的临床观察. 中华医学杂志, 2011, 91(23):1591-1594.
[11]  2. Rockwood CA Jr, Williams GR Jr, Burkhead WZ Jr. Débridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg (Am), 1995, 77(6):857-866.
[12]  3. Goutallier D, Postel JM, Bernageau J, et al. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res, 1994, (304):78-83.
[13]  6. Roy JS, Macdermid JC, Woodhouse LJ. Measuring shoulder function:a systematic review of four questionnaires. Arthritis Rheum, 2009, 61(5):623-632.
[14]  22. Gerber C, Sebesta A. Impingement of the deep surface of the subscapularis tendon and reflection pulley on the anterosuperior glenoid rim:a preliminary report. J Shoulder Elbow Surg, 2000, 9(6):483-490.
[15]  23. Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder:a preliminary report. J Bone Joint Surg (Am), 1972, 54(1):41-50.
[16]  4. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res, 1987, (214):160-164.
[17]  5. Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg (Am), 1986, 68(8):1136-1144.
[18]  7. Neviaser TJ, Neviaser RJ, Neviaser JS, et al. The four-in-one arthroplasty for the painful arc syndrome. Clin Orthop Relat Res, 1982, (163):107-112.
[19]  8. Wu PT, Jou IM, Yang CC, et al. The severity of the long head biceps tendinopathy in patients with chronic rotator cuff tears:macroscopic versus microscopic results. J Shoulder Elbow Surg, 2014, 23(8):1099-1106.
[20]  9. Refior HJ, Sowa D. Long tendon of the biceps brachii:sites of predilection for degenerative lesions. J Shoulder Elbow Surg, 1995, 4(6):436-440.
[21]  12. Miller C, Savoie FH. Glenohumeral abnormalities associated with full-thickness tears of the rotator cuff. Orthop Rev, 1994, 23(2):159-162.
[22]  14. Duff SJ, Campbell PT. Patient acceptance of long head of biceps brachii tenotomy. J Shoulder Elbow Surg, 2012, 21(1):61-65.
[23]  16. Hsu AR, Ghodadra NS, Provencher MT, et al. Biceps tenotomy versus tenodesis:a review of clinical outcomes and biomechanical results. J Shoulder Elbow Surg, 2011, 20(2):326-332.

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