早期肩关节镜下治疗中度冈上肌腱全层撕裂的疗效

Objective To investigate the clinical effect of early arthroscopic shoulder treatment of moderate full-thickness tear of the supraspinatus tendon. Methods A retrospective case control study was conducted to analyze the clinical data of 43 patients with moderate full-thickness supraspinatus tendon tear admitted to First Affiliated Hospital of Xi’an Jiaotong University from January 2018 to June 2020，including 17 males and 26 females，aged from 41 to 68 years［（55. 9±8. 2）years］. All patients had arthroscopic shoulder supraspinatus tendon suture and acromioplasty，including 22 patients underwent surgery within 1 month after persistent shoulder pain and motion limitation in early group and 21 patients between 1 month and 3 months in late group. The duration of operation and intraoperative blood loss were recorded. The visual analogue scale（VAS），American Shoulder and Elbow Society（ASES）score and Constant-Murley score were assessed before operation and at postoperative 3 weeks，6 weeks，3 months and 6 months. The complications were detected with 6 months after operation. Results All patients were followed up for 6-7 months ［（6. 4±0. 4）months］. There was no statistical significance in operation duration and intraoperative blood loss between the two groups（P>0. 05）. At 3 weeks，6 weeks，3 months and 6 months after operation， there showed significant decrease of VAS but significant increase of ASES and Constant-Murley scores compared to preoperation（P<0. 05）. At 3 weeks and 6 weeks after operation，the VAS in early group［（4. 4±0. 9）points，（3. 7±0. 8）points］was lower than that in late group［（5. 5± 1. 0）points，（4. 8±1. 1）points］；while the ASES score［（49. 1±4. 6）points，（56. 8±4. 1）points］and Constant-Murley score［（54. 1±4. 8）points，（64. 1±4. 4）points］in early group were higher than those in late group［ASES score：（45. 2±5. 4）points，（50. 3±5. 4）points；Constant-Murley score：（50. 5±3. 3）points，（58. 2±3. 9）points］（P<0. 05）. At 3 months and 6 months after operation，the two groups showed no statistical significance in these scores. There were no postoperative complications such as infection or nerve injury in both group within 6 months. Conclusion For moderate full-thickness tear of the supraspinatus tendon，arthroscopic shoulder surgery performed within 1 month after persistent shoulder pain and motion limitation can achieve better pain relief and faster functional rehabilitation in the short term compared with surgery performed 1-3 months later.