中国组织工程研究

中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (35): 5625-5629.doi: 10.3969/j.issn.2095-4344.2015.35.010

• 人工假体 artificial prosthesis • 上一篇    下一篇

关节置换与关节镜下修复肩关节复发性前脱位伴重度骨缺损：3年随访对比

陈  辉1，王  群1，燕双喜1，董天云1，邹海兵2   

  1. 1丹江口市第一医院，湖北省丹江口市  442700；2湖北医药学院，湖北省十堰市  442000
  • 收稿日期:2015-07-10 出版日期:2015-08-27 发布日期:2015-08-27
  • 通讯作者: 王群，主任医师，丹江口市第一医院，湖北省丹江口市 442700
  • 作者简介:陈辉，男，1971年生，湖北省丹江口市人，汉族，1995年湖北医药学院毕业，主治医师，主要从事骨关节外科研究。
  • 基金资助:

    湖北省科技厅课题：高脂饮食导致骨关节炎发生的机制研究(2013CFC031)

Arthroplasty versus arthroscopy for recurrent anterior dislocation of the shoulder joint with severe bone defects: 3-year follow-up 

Chen Hui1, Wang Qun1, Yan Shuang-xi1, Dong Tian-yun1, Zou Hai-bing2   

  1. 1Danjiangkou First Hospital, Danjiangkou 442700, Hubei Province, China; 2Hubei University of Medicine, Shiyan 442000, Hubei Province, China
  • Received:2015-07-10 Online:2015-08-27 Published:2015-08-27
  • Contact: Wang Qun, Chief physician, Danjiangkou First Hospital, Danjiangkou 442700, Hubei Province, China
  • About author:Chen Hui, Attending physician, Danjiangkou First Hospital, Danjiangkou 442700, Hubei Province, China
  • Supported by:

    the Program of Hubei Provincial Department of Science and Technology, No. 2013CFC031

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摘要：

背景：随着外科技术、重建材料技术的发展，关节置换在肩关节脱位中也得到了广泛应用，特别是各种定制型或装配型假体使得置换适应证明显提高。
目的：观察与随访关节镜与关节置换治疗肩关节复发性前脱位伴重度骨缺损的远期疗效。
方法：纳入肩关节复发性前脱位伴重度骨缺损患者144例，根据随机抽签分为治疗组与对照组，每组72例。对照组行关节镜下内固定治疗，治疗组行关节置换治疗。通过电话调查与复诊完成3年随访，记录患者Neer肩关节功能评分、肩关节活动度及并发症发生情况。
结果与结论：随访3年，治疗组的肩关节功能优良率90%明显高于对照组81%(P < 0.05)。两组3年随访时的前屈上举幅度都明显提高，而体侧外旋幅度明显降低，组内对比差异有显著性意义(P < 0.05)；同时3年随访时治疗组的前屈上举与体侧外旋幅度与对照组相比差异有显著性意义(P < 0.05)。治疗组随访期间的切口感染、肩关节脱位、固定物松动等并发症发生率明显低于对照组(P < 0.05)。提示相对于关节镜下内固定治疗，关节置换修复肩关节复发性前脱位伴重度骨缺损在随访远期可明显改善肩关节功能及肩关节活动度，并发症少，从而有效重建肩关节。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 植入物, 人工假体, 肩关节复发性前脱位, 关节镜, 关节置换, 重度骨缺损, 内固定, 随访

Abstract:

BACKGROUND: With the development of surgical techniques and reconstruction material technology, joint replacement has also been widely used in the dislocation of the shoulder; especially all kinds of custom-made or assembled prosthesis make replacement indications improved evidently.
OBJECTIVE: To investigate the long-term effects of arthroscopy or arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects.
METHODS: 144 patients with recurrent anterior dislocation of the shoulder joint with severe bone defects were enrolled in this study. They were divided into treatment group and control group based on a random drawing (n=72). The control group was given arthroscopic surgery, and the treatment group was subjected to arthroplasty. The 3 years of followed-up were done by telephone investigation and further consultation. Neer shoulder score, shoulder activity and complications were recorded. 
RESULTS AND CONCLUSION: After 3-year followed-up, the excellent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P < 0.05). The magnitude of the flexion in the 3-year followed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P < 0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistically significant differences compared to the control group in the 3-year followed-up (P < 0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during follow-up were significantly lower than in the control group (P < 0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term follow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Prosthesis Implantation, Arthroscopes, Shoulder Dislocation, Arthroplasty, Replacement, Follow-Up Studies

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