镜下“中国结”修复冈上肌腱腹交界区撕裂△

"Chinese knot" for arthroscopic repair of supraspinatus tear in muscle- tendon junction

摘要:

[目的] 介绍镜下“中国结”技术修复冈上肌腱腹交界区肩袖撕裂的手术技术和初步临床效果。[方法] 2020 年 2 月—2021 年 1 月采用“中国结”缝合技术治疗邻近腱腹交界区域肩袖撕裂患者 14 例，以爱惜邦缝合线在撕裂肩袖组织上呈倒三角分布编织“中国结”外观，适当张力下以外排锚钉固定，视情况结合“侧侧缝合”增强修复肩袖。[结果]14 例患者均顺利完成手术，无严重并发症，平均手术时间 (92.23±15.34) min，平均随访时间 (7.22±1.85) 个月。随术后时间推移，UCLA 评分、Constant 评分、肩关节活动范围显著增加，而 VAS 评分显著降低(P＜0.05)。术后 9 个月复查 MRI 均可观察到肩袖组织呈连续性影像。[结论]镜下“中国结”技术治疗邻近腱腹交界区域冈上肌撕裂临床效果可靠，技术可行。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical outcomes of "Chinese knot" for arthroscopic repair of supraspinatus tear in muscle-tendon junction. [Methods] Form February 2020 to January 2021, 14 patients underwent arthroscopic re- pair of supraspinatus tear in muscle-tendon junction with this Chinese knot technique. The Ethibond sutures were placed in the proximal end of the torn rotator cuff in a reverse triangle shape, like a "Chinese knot" in appearance, and then an anchor was inserted on the outside row, tied under the appropriate tension to repair the rupture. The side-side sutures were added to strengthen the rotator cuff repair if neces- sary. [Results] All the 14 patients were successfully operated on without serious complications, with operation time of (92.23±15.34) min. and were followed up for (7.22±1.85) months on average. The UCLA score, Constant score and range of motion of shoulder significantly in- creased (P＜0.05) , while VAS score significantly decreased over time (P＜0.05) . The MRI checks in regular revealed rotator cuff tissue heal- ing about 9 months after operation. [Conclusion] This “Chinese knot" technique for arthroscopic repair of supraspinatus tear in muscletendon junction is feasible, and achieves reliable clinical outcomes.