目的:比较关节镜下改良McLaughlin手术与双排锚钉固定治疗肩袖撕裂的疗效.方法:回顾性研究我院自2007年3月至2009年9月间,随访到的采用上述两种修补方法治疗的32例肩袖撕裂患者(33N)的疗效,其中骨道组17例(17肩),患者采用全关节镜下改良McLaughlin手术;锚钉组15例(16肩),患者采用关节镜下双排锚钉固定治疗.至少随访13个月,平均随访22个月,随访包括并发症、关节活动度、肌力、术后恢复日常生活的时间、恢复运动的时间、达到满意评分的时间、MRI评价术后肩袖愈合情况等,并进行两组手术前后UCLA、VAS评分比较.结果:两组患者手术后恢复日常生活时间、恢复运动时间差别有统计学意义:两组患者术后UCLA、VAS评分均较术前有明显改善,差异有统计学意义(P0.05).MRI发现锚钉组再撕裂1例,骨道组无再撕裂,两组差别无统计学意义(P>0.05).所有病例最终均对手术效果满意.结论:采用关节镜下McLaughlin手术与双排锚钉固定治疗肩袖损伤效果均优良,无统计学差异.前者在术后疼痛消失时间、恢复运动时间方面较后者更快,但两组患者的最后满意度无显著性差异.%Objective To discuss and evaluate the arthroscopic repair of rotator cuff tear with arthroscopic modified McLaughlin and double anchor techniques. Methods The clinical results of two different operation methods on 33 shoulders (32 patients) from Mar 2007 to Sep 2009 were compared.The rotator cuffs repair performed by arthroscopic modified McLaughlin technique were categorized into group A ( 17 shoulders, 17 patients) and by arthroscopic double-row anchor suture were categorized into group B ( 16 shoulders, 15 patients) respectively. All patients were followed up at least for 13 months after the procedures with an average of 22.0 months. The hospitalization time, complications, range of motion, muscular strength, UCLA and VAS scores were evaluated. The intact of the rotator cuff was evaluated by MRI. Results The scores of UCLA and VAS were improved significantly after the procedure in both groups (P ＜ 0.01 ) , but no significantly improvements were found between two groups. However, the restoration time of routine life and sports were significantly different between two groups. All of the cases were satisfied with the final outcomes. Conclusion Both the arthroscopic McLaughlin rotator cuff suture and double row anchor suture were stable and firm fixations.Avoid the shortcomings of anchor suture and open operations, the McLaughlin technique allowed early rehabilitation and return to sports.
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