穿线法套索固定冈上肌腱关节侧部分撕裂
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厦门大学附属福州市第二医院骨科

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福建省卫健委推广项目(2014022)


Threading lasso fixation for articular-sided partial-thickness supraspinatus tendon tears
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Department of Sports injury, XiaMen University, Second Hospital of FuZhou

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The technology projects of FuJian health commission(2014022)

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    摘要:

    [目的] 介绍穿线法套索固定冈上肌腱关节侧部分撕裂的手术技术和初步临床结果。 [方法] 收集2016年3月~2018年10月,共25例冈上肌腱关节侧部分撕裂患者,均在关节镜监视下,冈上肌腱撕裂端穿入高强度线,形成套索样结构,并通过外排锚钉固定撕裂的肌腱。术后进行随访。 [结果] 所有术后无并发症发生。肩关节VAS评分从术前(5.43±1.21)降低到末次随访(1.15±0.83)(t=14.908,P<0.01),ASES肩关节功能评分由术前(51.64±6.47)分,到末次随访(89.32±5.27)分,有明显改善(t=22.859,P<0.01);UCLA评分由术前(17.83±3.56)分,改善为(32.31±1.45)分(t=19.233,P<0.01),各组数据差别有统计学意义。 [结论] 对于冈上肌腱关节侧部分损伤的患者,采用关节镜下穿线法套索固定,能恢复肌腱张力,改善患肢功能,是一种有效的治疗方法。

    Abstract:

    [Objective] To introduce the surgical technique and clinical outcomes of threading lasso fixation for articular-sided partial-thickness tears of the supraspinatus tendon. [Methods] We collected data of 25 patients with articular-sided partial-thickness tears of the supraspinatus tendon who were treated between March 2016 and October 2018. Patients underwent arthroscopic repair of the tendon. High strength wire was passed through both sides of the proximal end of the articular-sided torn portion along the bursal-sided surface of the supraspinatus tendon, and form a lasso. Pulling the sutures, a lateral row of anchors was used to fix the sutures to the greater of the humerus .At the last follow-up,data were analyzed to evaluate the efficacy of the surgery. [Results] There were no post-operation complications. At the last follow-up, mean VAS score decreased from 5.43±1.21 before the surgery to 1.15±0.83 at the last follow-up (t=14.908, P<0.01), and the mean ASES score improved significantly from 51.64±6.47 to 89.32±5.27 (t=22.859, P<0.01). Mean UCLA score improved from 17.83±3.56 preoperatively to 32.31±1.45 (t=19.233, P<0.01). A statistically significant difference was observed in all scoring measures.[Conclusion] For patients with articular-sided partial-thickness tears of the supraspinatus tendon, arthroscopic repair using threading lasso fixation is a novel transtendinous technique. Tendon integrity is preserved in this method,which may result in improved function. Threading lasso fixation technique is an effective treatment.

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  • 收稿日期:2020-12-03
  • 最后修改日期:2021-01-17
  • 录用日期:2021-01-28
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