中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (15): 3188-3192.doi: 10.12307/2025.142

• 骨科植入物Orthopedic implants • 上一篇    下一篇

关节镜下单排固定与无结缝线桥固定治疗合并骨质疏松的肩袖损伤

张浩亮1，夏思佳1，展兵振1，冯  硕2，查国春2，李  程2   

  1. 1徐州医科大学，江苏省徐州市   221000；2徐州医科大学附属医院，江苏省徐州市   221006
  • 收稿日期:2024-01-14 接受日期:2024-02-29 出版日期:2025-05-28 发布日期:2024-11-05
  • 通讯作者: 李程，博士，副主任医师，徐州医科大学附属医院，江苏省徐州市 221006
  • 作者简介:张浩亮，男，1997年生，安徽省亳州市人，汉族，徐州医科大学在读硕士，主要从事关节骨科方面的研究。
  • 基金资助:
    徐州市卫健委青年医学科技创新面上项目(2021103507)，项目负责人：冯硕

Arthroscopic single-row fixation and knotless suture bridge fixation for rotator cuff injuries combined with osteoporosis

Zhang Haoliang1, Xia Sijia1, Zhan Bingzhen1, Feng Shuo2, Zha Guochun2, Li Cheng2   

  1. 1Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China; 2Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
  • Received:2024-01-14 Accepted:2024-02-29 Online:2025-05-28 Published:2024-11-05
  • Contact: Li Cheng, MD, Associate chief physician, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
  • About author:Zhang Haoliang, Master candidate, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
  • Supported by:
    a grant from Xuzhou Municipal Health Commission Youth Medical Technology Innovation (General Project), No. 2021103507 (to FS) 

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摘要：

文题释义：
肩袖损伤：是肩部疼痛和功能障碍的常见原因，发病机制是多因素的，包括反复性微创伤、年龄相关性退化、撞击和重大创伤，表现为肩关节运动受限、无力和疼痛的临床症状。
单排固定技术：是关节镜下肩袖修复的主要术式之一，通过单线穿过受损的肌腱向外牵拉固定，用来修复撕裂的肌腱，该手术可在很大程度上消除患者疼痛、恢复关节功能。

摘要
背景：关节镜下单排固定与无结缝线桥固定技术已普遍应用于治疗肩袖损伤，但对于合并骨质疏松的肩袖损伤的修复效果尚不明确。
目的：探讨关节镜下单排固定与无结缝线桥固定治疗合并骨质疏松的肩袖损伤的临床疗效。
方法：回顾性分析2018年1月至2022年8月徐州医科大学附属医院收治的122例接受关节镜治疗的合并骨质疏松的肩袖损伤患者，根据治疗方案分为2组，其中单排固定患者63例(单排组)，无结缝线桥固定患者59例(缝线桥组)。比较两组患者术前和术后1年时的疼痛目测类比评分、美国加州大学肩关节评分、美国肩肘外科医师学会评分、Constant-Murley肩关节功能评分和肩关节活动度；术后1年采用Sugaya分型标准评估肩袖再撕裂情况；记录两组患者并发症发生情况。
结果与结论：①所有患者均获得1年以上随访；术后两组患者均未发生切口感染、神经损伤等并发症；②两组患者术后1年目测类比评分、美国加州大学肩关节评分、美国肩肘外科医师学会评分、Constant-Murley评分以及肩关节活动度均较术前显著改善(P < 0.05)；缝线桥组术后1年目测类比评分、美国加州大学肩关节评分、美国肩肘外科医师学会评分、Constant-Murley评分以及肩关节活动度均优于单排组(P < 0.05)；③术后1年，单排组再撕裂率为22%(14/63)，显著高于缝线桥组7%(4/59)，差异有显著性意义(χ2=5.777，P=0.016)；④提示关节镜下单排固定与无结缝线桥固定治疗合并骨质疏松的肩袖损伤均能获得满意的临床疗效，但无结缝线桥固定修复效果更好，术后再撕裂率更低。

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: 肩袖损伤, 单排固定, 无结缝线桥技术, 骨质疏松, 关节镜

Abstract: BACKGROUND: Arthroscopic single-row fixation with knotless suture bridge fixation techniques have been commonly used in the treatment of rotator cuff injuries, but the clinical efficacy in rotator cuff injuries combined with osteoporosis is unclear.
OBJECTIVE: To investigate the clinical efficacy of arthroscopic single-row fixation versus knotless suture bridge fixation in the treatment of rotator cuff injuries combined with osteoporosis.
METHODS: One hundred and twenty-two patients with rotator cuff injuries combined with osteoporosis who underwent arthroscopic treatment admitted to Affiliated Hospital of Xuzhou Medical University between January 2018 and August 2022 were retrospectively analyzed. They were divided into two groups according to the treatment plan. There were 63 patients with single-row fixation (single-row group) and 59 patients with knotless suture-bridge fixation (suture-bridge group). The visual analog scale scores for pain, University of California Los Angeles Shoulder Score, American Shoulder and Elbow Surgeons Score, Constant-Murley score, and shoulder range of motion were compared between the two groups at the preoperative and 1 year postoperative periods. Rotator cuff re-tears were evaluated at 1 year postoperatively using the Sugaya staging criteria. The occurrence of complications was recorded in both groups.
RESULTS AND CONCLUSION: (1) All patients received more than 1-year follow-up. No complications such as incision infection and nerve injury occurred in both groups after surgery. (2) Postoperative visual analog scale scores, University of California Los Angeles Shoulder Score, American Shoulder and Elbow Surgeons Score, Constant-Murley scores, and shoulder range of motion were significantly improved 1 year postoperatively in both groups compared with the preoperative period (P < 0.05). Visual analog scale scores, University of California Los Angeles Shoulder Score, American Shoulder and Elbow Surgeons Score, Constant-Murley scores, and shoulder range of motion were better in the suture-bridge group than in the single-row group 1 year postoperatively (P < 0.05). (3) At 1 year postoperatively, the re-tear rate in the single-row group [22% (14/63)] was significantly higher than that in the suture-bridge group [7% (4/59)], and the difference between the two groups was statistically significant (χ2=5.777, P=0.016). (4) It is indicated that arthroscopic single-row fixation and knotless suture bridge fixation for rotator cuff injuries combined with osteoporosis both yielded satisfactory clinical outcomes, but knotless suture bridge fixation was more clinically effective, with a lower rate of postoperative retear.

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: rotator cuff tear, single-row fixation, knotless suture bridge technique, osteoporosis, arthroscopy

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