CAJ | 학술논문

目的探讨关节镜治疗巨大肩袖损伤的临床效果及影响因素.方法自2007年9月至2009年6月接受手术治疗的巨大肩袖损伤患者16例,男6例,女10例;平均年龄61.5岁.采取关节镜下双排重建对损伤肩袖进行修复.记录术前及最终随访时的疼痛、活动范围、前屈上举的肌肉力量以及功能评分,进行配对t检验;并按不同年龄、病程进行分组,进行统计学分析.结果所有患者均顺利愈合,术前疼痛视觉模拟评分(visual analogue score,VAS)为5.6,前屈上举为69.1°,外旋为14.7°,内旋达L1水平,Constant-Murley评分为39,加州大学洛杉矾分校评分(UCLA)为10.4,肩关节简单评分(SST)为2.8,前屈上举的肌力相当于健侧的10.7%.术后VAS为1.7,前屈上举为151.2°,外旋为32.2°,内旋达T10水平,Constant-Murley评分为85.6,UCLA为28,SST为8.8,前屈上举的肌力为健侧的65.0%.术后与术前在疼痛、活动范围、肌力及功能方面差异均有统计学意义(P<0.01).不同性别和不同病程在手术前后的差异均无统计学意义.结论通过关节镜手术对损伤的肩袖进行双排重建可获得较为满意的临床治疗结果.
목적 탐토관절경치료거대견수손상적림상효과급영향인소.방법자2007년9월지2009년6월접수수술치료적거대견수손상환자16례,남6례,녀10례;평균년령61.5세.채취관절경하쌍배중건대손상견수진행수복.기록술전급최종수방시적동통、활동범위、전굴상거적기육역량이급공능평분,진행배대t검험;병안불동년령、병정진행분조,진행통계학분석.결과 소유환자균순리유합,술전동통시각모의평분(visual analogue score,VAS)위5.6,전굴상거위69.1°,외선위14.7°,내선체L1수평,Constant-Murley평분위39,가주대학락삼반분교평분(UCLA)위10.4,견관절간단평분(SST)위2.8,전굴상거적기력상당우건측적10.7%.술후VAS위1.7,전굴상거위151.2°,외선위32.2°,내선체T10수평,Constant-Murley평분위85.6,UCLA위28,SST위8.8,전굴상거적기력위건측적65.0%.술후여술전재동통、활동범위、기력급공능방면차이균유통계학의의(P<0.01).불동성별화불동병정재수술전후적차이균무통계학의의.결론통과관절경수술대손상적견수진행쌍배중건가획득교위만의적림상치료결과.
Objective To evaluate the clinical results of arthroscopic repair of massive rotator cuff tear. Methods The study involved 16 patients with massive rotator cuff tears treated arthroscopically from September 2007 to June 2009. There were 6 males and 11 females at average age 61.5 years (45-75 years). The rotator cuff tears was repaired with arthroscopic double-row reconstruction. The range of motion, pain, strength of flexed elevation and function evaluation score were all recorded before operation and at final follow-up. The results were evaluated by t test and compared according to age and course of disease. Results All patients were healed without complications and the outcome was improved significantly ( P < 0.01 ). The mean VAS score was improved from preoperative 5.6 to postoperative 1.7,the average forward flexion from 69. 1°to 151.2°, the average external rotation from 14.7° to 32.2°, and internal rotation from L1 level to T10, the mean Constant-Murle from 39 to 85, the mean UCLA from 10.4 to 28, the mean SST from 2.8 to 8.8 and the strength of flexed elevation from 10.7% of normal side to 65.0%. Compared with preoperation, there was statistical difference in aspects of pain, range of motion, muscle strength and function in postoperation (P < 0.01 ). Conclusion Arthroscopic doublerow fixation can attain satisfactory results in repair of massive rotator cuff tear.