肩关节镜下清理治疗钙化性冈上肌腱炎的疗效分析Effectiveness of arthroscopic removal of the calcific deposits of calcifying tendonitis of the supraspinatus tendon
李苏皖;付国建;刘洪业;刘朝晖;何仿;
摘要(Abstract):
[目的]探讨肩关节镜下清理冈上肌腱内钙化灶治疗钙化性冈上肌腱炎的手术疗效。[方法]自2010年1月~2011年7月对在本院就诊的9例确诊为钙化性冈上肌腱炎的患者行肩关节镜下清理冈上肌腱内钙化灶治疗,术前患者肩关节疼痛剧烈伴活动受限,经正规保守治疗3个月以上无效。术中清理肩峰下间隙,切除炎性滑囊,常规行肩峰成形术,彻底清理冈上肌腱内的钙化灶。术前及术后随访均采用VAS疼痛评分、Constant-Murley评分和X线检查对患者进行评估并做手术前后的对比分析。[结果]术后平均随访6个月,所有患者肩关节疼痛及活动受限均得到明显改善或完全缓解,VAS疼痛评分术前(8.33±1.0)分,术后最后一次复查为(1.44±0.88)分,术前、术后VAS评分差异有统计学意义(P<0.01)。Constant-Murley评分术前为(50.44±10.06)分,术后最后一次复查为(93±4.21)分,术前、术后Constant-Murley评分差异有统计学意义(P<0.01)。术后复查X线片显示冈上肌腱内钙化灶均已完整清除。[结论]关节镜下行冈上肌腱内钙化灶清理,具有手术创伤小、病灶清除彻底、对肩袖及盂肱关节损伤小、术后康复快等优点,临床疗效确切。
关键词(KeyWords): 钙化性冈上肌腱炎;肩袖;肩关节;关节镜
基金项目(Foundation):
作者(Author): 李苏皖;付国建;刘洪业;刘朝晖;何仿;
Email:
DOI:
参考文献(References):
- [1]Spivey JL,Carrell TM.Severe pain in the shoulder with no history oftrauma.Calcific tendinitis[J].JAAPA,2009,22:59-60.
- [2]Ifesanya A,Scheibel M.Arthroscopic treatment of calcifying tendonitisof subscapularis and supraspinatus tendon:a case report[J].KneeSurg Sports Traumatol Arthrosc,2007,15:1473-1477.
- [3]Hurt G,Baker CL.Calcific tendinitis of the shoulder[J].Orthop ClinNorth Am,2003,34:567-575.
- [4]Uhthoff HK,Loehr JW.Calcific tendinopathy of the rotator cuff:path-ogenesis,diagnosis,and management[J].J Am Acad Orthop Surg,1997,5:183-191.
- [5]Rompe JD,Zoellner J,Nafe B.Shock wave therapy versus conventionalsurgery in the treatment of calcifying tendinitis of the shoulder[J].Clin Orthop,2001,387:72-82.
- [6]McKendry RJR,Unthoff HK,Sarkar K,et al.Calcifying tendonitis ofthe shoulder:prognostic value of clinical,histologic,and radiologicfeatures in 57 surgically treated cases[J].J Rheumatol,1982,9:75-80.
- [7]姜春岩,冯华,王满宜,等.钙化性肩袖肌腱炎的关节镜治疗[J].中华手外科杂志,2005,21:3-5.
- [8]OzkoG,Akpinar S,Hersekli MA,et al.Arthroscopic treatment ofrotator cuff calcifying tendinitis[J].Acta Orthop Traumatol Turc,2002,36:413-416.
- [9]贺业腾,闫新峰,张明,等.是否保留肩袖对肩巨大钙化性肌腱炎手术疗效的影响[J].中国矫形外科杂志,2007,15:1293-1295.
- [10]Porcellini G,Paladini P,Campi F,et al.Arthroscopic treatment ofcalcifying tendinitis of the shoulder:clinical and ultrasonographic fol-low-up findings at two to five years[J].J Shoulder Elbow Surg,2004,13:503-508.