首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Arthroscopic Removal of Chronic Symptomatic Calcifications of the Supraspinatus Tendon Without Acromioplasty
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Arthroscopic Removal of Chronic Symptomatic Calcifications of the Supraspinatus Tendon Without Acromioplasty

机译:关节镜下去除无虹膜成形术的慢性肌腱的症状性钙化

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Background: Little knowledge exists on postoperative recovery of pain and shoulder function following arthroscopic removal of calcific deposits of the supraspinatus tendon (ACDSSP). Certain factors may influence outcome, including acromial morphology. Purpose: To examine postoperative recovery following ACDSSP without acromioplasty and to analyze influential outcome factors. Study Design: Case series; Level of evidence, 4. Methods: This prospective study evaluated 82 patients (105 shoulders) after ACDSSP without acromioplasty. Time periods for postoperative recovery of pain and subjective shoulder function were recorded. The absolute and normalized Constant scores (CSabs and CSnorm, respectively), Oxford Shoulder Score (OSS), DASH score (DS), and subjective shoulder value (SSV) were measured after a mean follow-up of 33.9 months. Analyzed outcome factors included localization of the calcific deposit (CD), acromial morphology, radiographic extent of CD removal, type of nonoperative treatment, and preoperative duration of symptoms. Results: Mean duration of postoperative pain was 2.2 weeks. Recovery of subjective shoulder function required 11.1 weeks on average. Mean ± standard deviation follow-up values were 91.1 ± 8.3 for CSabs, 104.2% ± 8.2% for CSnorm, 13.1 ± 2.6 for OSS, 1.81 ± 4.59 for DS, and 93.8% ± 10.7% for SSV. Abduction was significantly (P = .008) lower in patients with type III (170° ± 17.5°) compared with type I (174° ± 20.7°) and type II (179° ± 4.5°) acromions. Also, abduction was significantly (P = .001) lower in patients with long-standing symptoms (>72 months). Minor calcific remnants were found in 19 of 105 shoulders (18.1%), but affected neither postoperative recovery nor outcome. Conclusion: ACDSSP without acromioplasty yielded favorable outcomes and effected fast remission of pain regardless of acromial morphology. However, recovery of subjective shoulder function required almost 3 months on average. Minimal restriction of abduction occurred in patients with hook-shaped acromions and long-standing preoperative symptoms. The present data do not support routine performance of acromioplasty.
机译:背景:关节镜下去除上棘肌腱钙化沉积物(ACDSSP)后,术后疼痛和肩部功能恢复的知识很少。某些因素可能会影响结局,包括肩峰形态。目的:检查无肩部成形术的ACDSSP术后恢复情况,并分析影响预后的因素。研究设计:案例系列;证据级别,第4级。方法:该前瞻性研究评估了82例ACDSSP患者(不行肩部成形术)后的105例肩膀。记录术后疼痛和主观肩部功能恢复的时间。在平均随访33.9个月后,测量了绝对和标准化的Constant评分(分别为CSabs和CSnorm),Oxford肩膀评分(OSS),DASH评分(DS)和主观肩膀值(SSV)。分析的结局因素包括钙化沉积物(CD)的位置,肩峰形态,CD去除的影像学范围,非手术治疗的类型以及术前症状的持续时间。结果:术后平均疼痛持续时间为2.2周。恢复主观肩部功能平均需要11.1周。 CSabs的平均值±标准差随访值分别为91.1±8.3,CSnorm的平均值为104.2%±8.2%,OSS的平均值为13.1±2.6,DS的平均值为1.81±4.59,SSV的平均值为93.8%±10.7%。与I型(174°±20.7°)和II型(179°±4.5°)肩峰相比,III型(170°±17.5°)患者的外展明显降低(P = 0.008)。同样,长期症状(> 72个月)的患者的绑架明显降低(P = 0.001)。在105例肩中有19例发现了少量钙化残余物(18.1%),但既不影响术后恢复,也不影响预后。结论:无肩部成形术的ACDSSP取得了良好的效果,并且无论肩部形态如何,均可实现疼痛的快速缓解。但是,恢复主观肩部功能平均需要近3个月。钩形肩峰和长期术前症状的患者外展限制最小。目前的数据不支持常规的肩峰成形术。

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