A Comparative Study of Arthroscopic Treatment of Acromion Impingement Syndrome with Tendinitis of Biceps Brachii Long Head (LHBT) in High Joint and Low Intertrochanteric Groove with Small Incision
WU Fengchun, LIAO Mingxin, HUANG Jiexin, et al
Nanping First Hospital Affiliated to Fujian Medical University, Fujian Nanping 353000, China
摘要目的: 探讨关节镜下高位关节内与小切口低位关节外结节间沟下肱二头肌长头腱 (Long Head of the Biceps Tendon,LHBT)切断固定治疗伴有肱二头肌长头肌腱炎肩峰撞击综合征(subacromial impingement syndrome,SIS)的对照研究。方法: 选取2019年月12月至2022年12月在我院诊治的伴有肱二头肌长头肌腱炎SIS患者92例,其中45例接受关节镜下高位关节内LHBT切断固定治疗(观察A组),47例接受小切口低位关节外结节间沟下LHBT切断固定治疗(观察B组),比较两组治疗前后的加州大学 (UCLA)肩关节评分系统各维度评分及总分、Constant肩关节评分评分、美国肩肘关节医师协会(ASES)评分,以及临床治疗疗效。结果: 治疗后,两组UCLA各维度评分、患者满意度及总分较治疗前均升高(P<0.05),但与观察B组比较,观察A组UCLA各维度评分、患者满意度及总分治疗前后的差值明显更低(P<0.05)。治疗后,两组Constant、ASES评分较治疗前均升高(P<0.05),但与观察B组比较,观察A组Constant、ASES评分治疗前后的差值明显更低(P<0.05)。与观察B组95.74%比较,观察A组临床治疗总有效率80.00%明显更低(P<0.05)。结论: 与关节镜下高位关节内LHBT切断固定治疗相比较,小切口低位关节外结节间沟下LHBT切断固定治疗伴有肱二头肌长头肌腱炎SIS患者,可更有效促进肩关节功能恢复,提高临床治疗疗效。
Abstract：Objective: To investigate the comparative study of arthroscopic high intra-articular and small incision low extra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii. Methods: From December 2019 to December 2022, 92 patients with ASES accompanied with tendinitis of biceps brachii long head were selected in our hospital. Among them, 45 patients were treated with high intra-articular LHBT amputation and fixation under arthroscopy (observation group A), and 47 patients were treated with low intra-articular LHBT amputation and fixation under intertrochanteric groove (observation group B). The scores of each dimension, total score and Constant of the University of California (UCLA) shoulder joint scoring system before and after treatment were compared. Results: After treatment, both UCLA scores of each dimension, patient satisfaction, and total scores were increased (P<0.05), but the differences in UCLA scores, patient satisfaction, and total scores before and after treatment in Group A were significantly lower (P<0.05). After treatment, Constant and ASES scores increased in both groups compared to before treatment (P<0.05), but the difference between the Constant and ASES scores of Group A before and after treatment is significantly lower (P<0.05). Compared with 95.74%, 80.00% was significantly less effective (P<0.05). Conclusion: Compared with arthroscopic treatment of high-level intra-articular LHBT amputation and fixation, small-incision low-level intra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii can effectively promote the recovery of shoulder joint function and improve the clinical curative effect.
吴冯春, 廖明新, 黄杰鑫, 林伟明, 叶剑, 高招文. 关节镜下高位关节内与小切口低位关节外结节间沟下LHBT切断固定治疗伴有肱二头肌长头肌腱炎SIS的对照研究[J]. 河北医学, 2024, 30(4): 618-623.
WU Fengchun, LIAO Mingxin, HUANG Jiexin, et al. A Comparative Study of Arthroscopic Treatment of Acromion Impingement Syndrome with Tendinitis of Biceps Brachii Long Head (LHBT) in High Joint and Low Intertrochanteric Groove with Small Incision. HeBei Med, 2024, 30(4): 618-623.
[1] Kooistra B,Gurnani N,Weening A,et al.Tenotomy or tenodesis for tendinopathy of the long Head of the biceps brachii:an updated systematic review and meta-analysis.[J].Arthrosc Sports Med Rehabil,2021,3(4):1199-1209. [2] Hughes JD,Gibbs CM,Drummond M,et al.Failure rates and clinical outcomes after treatment for long-head biceps brachii tendon pathology:a comparison of three treatment types.[J].JSES Int,2021,5(4):630-635. [3] 曲博,石向明,王成健,等.MSCT联合MRI在肩关节损伤诊断及损伤程度判定方面的价值[J].河北医科大学学报,2024,45(1):35-39. [4] 龚礼,周明,范少勇,等.关节镜下两种肌腱固定治疗肱二头肌长头近端腱损伤的比较[J].中国组织工程研究,2023,27(28):4533-4538. [5] 任晔,祁军,游洪波,等.两种手术方式治疗高龄肩袖损伤合并肱二头肌腱长头腱损伤疗效比较[J].实用骨科杂志,2021,27(7):577-582. [6] 吴晓翔,郑卫丛,常乾震,等."筋骨平衡,以筋为先"理论在肩峰下撞击综合征中的应用探讨[J].山东中医杂志,2023,42(5):442-447. [7] 雷博艺,周百刚,冯宏伟,等.关节镜下单纯切断术与切断固定术治疗肱二头肌长头肌腱炎的临床疗效及安全性比较[J].检验医学与临床,2022,19(23):3279-3282. [8] 高秋明,丁浩亮,孙健.肩关节镜下肱二头肌长头肌腱转位重建肩关节上关节囊修复巨大肩袖撕裂[J].中华创伤杂志,2021,37(3):222-228.
2024, Vol. 30 
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