关节盂软骨损伤的镜下手术治疗

Arthroscopic treatment of glenolabral articular disruption

摘要:

［目的］ 探讨关节镜下盂唇修补治疗关节盂软骨 （glenolabral articular disruption, GLAD） 损伤的临床效果。［方法］ 2011 年 1 月—2018 年 12 月，12 例 GLAD 损伤接受关节镜下盂唇修补手术治疗，均为男性，平均年龄 （21.60±5.22） 岁。［结果］所有患者均顺利完成手术，手术时间平均（28.50±7.50） min，术中失血量平均（32.30±4.20） ml。患者术后均无感染、关节腔积血、神经损伤、关节粘连并发症发生。所有患者平均随访（13.60±3.65）个月，完全负重活动时间为（15.70±1.50）周。 末次随访时，ASES 评分、Constant-Murley 评分、Rowe 评分均较术前显著改善 （P<0.05），但患者术后肩关节前屈上举、中立位体侧内旋及体侧外旋活动度与术前相比无明显差异（P>0.05）。影像检查见盂肱对位和内置物位置良好。［结论］关节镜下前方关节囊清创修补治疗 GLAD 损伤的临床效果满意。

Abstract:

[Objective] To evaluate the clinical outcomes of arthroscopic labrum repair for glenolabral articular disruption (GLAD) . [Methods] From January 2011 to December 2018, 12 patients who were all males and aged (21.60±5.22) years on an average underwent ar- throscopic labial repair for GLAD injury. [Results] All patients had the operations performed successfully with operation time of (28.50± 7.50) min, intraoperative blood loss of (32.30±4.20) ml. No complications, such as infection, hemoarthrosis, nerve injury and joint adhesion, happened in anyone of them. All patients were followed up for (13.60±3.65) months on average with the time to resume full weight-bearing activity of (15.70±1.50) weeks. At the last follow-up, the ASES, Constant-Murley and Rowe scores significantly improved compared with those preoperatively (P＜0.05) , but the range of motions, including shoulder forward flexion and upward lift, lateral internal rotation, as well as lateral external rotation in neutral position remained unchanged (P＞0.05) . Radiographic examination showed that the glenohumeral alignment and implants were in good position. [Conclusion] The clinical outcomes of arthroscopic debridement and repair of anterior joint capsule is satisfactory for GLAD.