镜下“8”字双排无结锚钉修复巨大肩袖撕裂△

Arthroscopic figure 8 double-row knotless anchors for massive rotator cuff tears

摘要:

［目的］介绍镜下“8”字双排无结锚钉技术修复巨大肩袖撕裂的手术技术和初步临床效果。［方法］对 24 例巨大肩袖撕裂患者行镜下“8”字双排无结锚钉修复治疗。先行关节镜肩关节清理，松解肩袖断端，然后于肱骨头软骨外侧缘与肩袖足印区内侧合适位置钻孔，置入 2 枚带线锚钉。使用缝合钩或过线器将 8 根缝线游离端交叉穿过撕裂肩袖肌腱，不打结。拉紧缝线，使肩袖游离端复位至足印区，分别于肱骨大结节外缘置入 2 枚外排无结锚钉固定缝线，并使 8 根缝线均匀覆盖撕裂肩袖。［结果］ 24 例患者均顺利完成镜下修复手术，术后未出现严重并发症。术后随访 12~36 个月。末次随访时，VAS 评分、 UCLA 功能评分、Constant 功能评分均较术前显著改善 （P<0.05）。X 线片显示关节间隙无明显变窄或退行性改变。［结论］ 镜下“8”字双排无结锚钉技术治疗巨大肩袖撕裂可显著改善肩关节功能，短期临床效果满意。

Abstract:

[Objective] To introduce the surgical technique and preliminary clinical results of arthroscopic figure 8 double-row knot- less anchors for massive rotator cuff tears. [Methods] A total of 24 patients received abovementioned arthroscopic repair of massive rotator cuff tears. Firstly, two anchor on the internal row were placed on proper position on the conjunction of lateral cartilage border and rotator cuff foot print after arthroscopic debridement. Furthermore, the free ends of the eight sutures were crossed through the torn rotator cuff ten- don by a suture hook or a thread crosser without tying. Moreover, the 8 sutures were pull to reduce the end of torn rotator cuff to the original foot print and fastened on the outer humeral greater tuberosity by two knotless anchors to cover the torn rotator cuff evenly. [Results] All the 24 patients underwent endoscopic repair successfully, with no serious complications. With time of follow-up lasted for 12~36 months, the VAS, UCLA and Constant-Murley scores significantly improved compared with preoperative scores (P＜0.05) . Radiographs showed no sig- nificant narrowing or degenerative changes in the subacromial and glenohumeral spaces. [Conclusion] The arthroscopic figure 8 doublerow knotless anchors for massive rotator cuff tears do significantly improve shoulder joint function, and get satisfactory clinical outcomes in short-term.