肩关节镜下改良缝合桥术对老年肩袖损伤患者术后肩关节功能和影像结局的影响^*

Effect of modified suture bridge under shoulder arthroscopy on postoperative shoulder joint function and imaging outcome in elderly patients with rotator cuff injury

摘要

目的 探讨肩关节镜下改良缝合桥术对老年肩袖损伤患者术后肩关节功能和影像结局的影响。方法 回顾性分析中国人民解放军联勤保障部队第九○四医院2021年1月—2024年1月收治的120例老年肩袖损伤患者的临床资料。根据手术方式不同,将患者分为对照组58例,观察组62例。对照组采用肩关节镜下传统缝合桥术,观察组采用肩关节镜下改良缝合桥术。比较两组患者一般资料、临床疗效、肩关节视觉模拟疼痛量表(VAS)评分、肩关节功能及肩关节活动度情况。结果 观察组患者肩袖总愈合率高于对照组(P＜0.05);两组患者术后3个月、6个月VAS评分均低于术前(P＜0.05),观察组患者术后3个月、6个月的VAS评分均低于对照组(P＜0.05);两组术后3个月、6个月美国肩肘外科医师协会(ASES)评分、美国加州大学洛杉矶分校(UCLA)评分、肩关节功能(Constant)评分均高于术前(P＜0.05),观察组术后3个月、6个月ASES评分、UCLA评分及Constant评分均高于对照组(P＜0.05);两组术后3个月、6个月前屈和外旋活动度均高于术前(P＜0.05),观察组术后3个月、6个月前屈、外旋活动度均高于对照组(P＜0.05)。结论 肩关节镜下改良缝合桥术较传统缝合桥术更能促进老年肩袖损伤患者的肩袖愈合,改善术后肩关节功能,减轻术后疼痛,并改善肩关节活动度。

Abstract

Objective To investigate the effects of modified suture bridge technique under shoulder arthroscopy on postoperative shoulder function and imaging outcomes in elderly patients with rotator cuff injuries. Methods A retrospective analysis was conducted on the clinical data of 120 elderly patients with rotator cuff injuries treated at the 904th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from January 2021 to January 2024. According to the different surgical methods, the patients were divided into a control group of 58 cases and an observation group of 62 cases. The control group was treated with the traditional arthroscopic rotator cuff suture bridge technique, while the observation group was treated with the modified arthroscopic rotator cuff suture bridge technique. General patient data, clinical efficacy, visual analog scale (VAS) scores for shoulder pain, shoulder function, and shoulder range of motion were statistically analyzed. Results The overall rotator cuff healing rate in the observation group was higher than that in the control group (P<0.05). In both groups, VAS scores at 3 and 6 months postoperatively were lower than those before surgery (P<0.05), and the VAS scores of the observation group at 3 and 6 months postoperatively were lower than those of the control group (P<0.05). The American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and Constant shoulder score at 3 and 6 months postoperatively were all higher than the preoperative values in both groups (P < 0.05), and these scores at 3 and 6 months postoperatively were higher in the observation group than in the control group (P < 0.05). In addition, forward flexion and external rotation at 3 and 6 months postoperatively were higher than the preoperative levels in both groups (P < 0.05), and the observation group showed greater forward flexion and external rotation at 3 and 6 months postoperatively compared with the control group (P < 0.05). Conclusion Compared to the traditional suture bridge technique, the modified suture bridge technique under shoulder arthroscopy more effectively promotes rotator cuff healing, improves postoperative shoulder function, alleviates postoperative pain, and enhances shoulder range of motion in elderly patients with rotator cuff injuries.

关键词

肩关节镜 / 肩袖损伤 / 改良缝合桥

Key words

Shoulder arthroscopy / Rotator cuff injury / Modified suture bridge