标题：无结缝线桥固定术与有结缝线桥固定术对肩袖损伤患者关节活动度、ASES评分和术后并发症的影响

      作者：王挺 1，王华磊 1，郭雄飞 1，汤立新 2    南阳市中心医院骨一科 1、骨科一病区 2，河南 南阳 473000

      卷次： 2024年35卷14期

      【摘要】 目的 探讨无结缝线桥固定术与有结缝线桥固定术对肩袖损伤患者关节活动度、美国肩肘外科协会评分(ASES)和术后并发症的影响。方法 回顾性分析 2020年6月至2022年6月于南阳市中心医院就诊的104例肩袖损伤患者的临床资料，按治疗方式的不同将患者分为对照组50例和研究组54例。对照组患者接受有结缝线桥固定术，研究组患者接受无结缝线桥固定术。术后随访12个月，比较两组患者术前及术后12个月的前屈活动度、外旋活动度、疼痛视觉模拟评分(VAS)、ASES评分、肩关节Constant评分、加州大学洛杉矶分校肩关节功能评分(UCLA)、肩袖再撕裂发生情况以及术后并发症发生情况。结果 术前两组患者的前屈活动度、外旋活动度以及VAS评分比较差异均无统计学意义(P>0.05)；术后12个月，两组患者的前屈活动度、外旋活动度明显高于术前，VAS评分明显低于术前，差异均有统计学意义(P<0.05)，但两组患者术后12个月的前屈活动度、外旋活动度和VAS评分比较差异均无统计学意义(P>0.05)；术前两组患者的ASES、肩关节Constant、UCLA、VAS评分比较差异均无统计学意义(P>0.05)；术后12个月，两组患者的ASES、肩关节Constant、UCLA、VAS评分明显高于术前，差异均有统计学意义(P<0.05)，但两组患者术后 12个月的ASES评分、肩关节Constant评分和UCLA评分比较差异均无统计学意义(P>0.05)；研究组患者的肩袖再撕裂率为1.85%，明显低于对照组的12.00%，差异有统计学意义(P<0.05)；研究组患者的术后并发症率为5.56%，略低于对照组的8.00%，但差异无统计学意义(P>0.05)。结论 无结缝线桥固定术与有结缝线桥固定术临床治疗效果接近，但无结缝线桥固定术可显著降低肩袖再撕裂率。
      【关键词】 肩袖损伤；无结缝线桥固定术；有结缝线桥固定术；关节活动度；并发症
      【中图分类号】 R684 【文献标识码】 A 【文章编号】 1003—6350（2024）14—2007—05

Effects of knotless and knotted suture bridge fixation on range of motion, ASES scores, and postoperativecomplications in patients with rotator cuff injury.
WANG Ting 1, WANG Hua-lei 1, GUO Xiong-fei 1, TANG Li-xin 2.The First Department of Orthopedics 1, Ward Ⅰ of Department of Orthopedics 2, Nanyang Central Hospital, Nanyang 473000,Henan, CHINA
【Abstract】 Objective To explore the effects of knotless and knotted suture bridge fixation on range of motion,scores of American Shoulder and Elbow Surgeons (ASES), and postoperative complications in patients with rotator cuffinjury. Methods A retrospective analysis was performed on the clinical data of 104 patients with rotator cuff injury inNanyang Central Hospital between June 2020 and June 2022. According to different treatment methods, the patientswere divided into a control group (50 cases, knotted suture bridge fixation) and a study group (54 cases, knotless suturebridge fixation). All the patients were followed up for 12 months after surgery. The range of motion (anterior flexion, ex-ternal rotation), scores of Visual Analogue Scale (VAS), ASES, shoulder Constant, and University of California at LosAngeles (UCLA), occurrence of rotator cuff re-tear, and postoperative complications were compared between the twogroups before and at 12 months after surgery. Results Before surgery, there was no significant difference in range ofmotion (anterior flexion, external rotation) or VAS score between the two groups (P>0.05). At 12 months after surgery,range of motion (anterior flexion, external rotation) was significantly increased, and VAS scores were significantly de-creased in both groups, with statistically significant differences (P<0.05); there was no significant difference in anteriorflexion, external rotation or VAS score between the two groups (P>0.05). Before surgery, there was no significant differ-ence in scores of ASES, shoulder Constant, UCLA, and VAS between the two groups (P>0.05). At 12 months after sur-gery, scores of ASES, shoulder Constant, UCLA, and VAS were significantly increased in both groups, and the differenc-es were statistically significant (P<0.05); there was no significant difference in the above scores between the two groups(P>0.05). The rotator cuff re-tear rate in study group was significantly lower than that in the control group (1.85% vs12.00%, P<0.05). There was no significant difference in the incidence of postoperative complications between the twogroups (5.56% vs 8.00%, P>0.05). Conclusion The clinical curative effect of knotless and knotted suture bridge fixa-tion is similar. However, knotless suture bridge fixation can significantly decrease rotator cuff re-tear rate.
      【Key words】 Rotator cuff injury; Knotless suture bridge fixation; Knotted suture bridge fixation; Range of mo-tion; Complication