肩关节镜下单、双排缝合巨大肩袖撕裂的临床疗效比较

Clinical Efficacy Comparison of Arthroscopic Single-Row and Double-Row Suture Repair for Massive Rotator Cuff Tears

摘要: 目的：对比肩关节镜下单排缝合与双排缝合治疗巨大肩袖撕裂的临床疗效。方法：我们在青岛市市立医院收集了70例巨大肩袖撕裂患者，所有患者均收治于2022年7月~2023年1月期间，根据手术方式不同分为单排组和双排组，每组35例。单排组给予关节镜下单排缝合治疗，双排组给予关节镜下双排缝合治疗。随访两组患者术后6个月肩关节临床功能恢复情况及核磁共振影像肩袖完整情况。结果：两组患者术前ASES、CMS、UCLA、OSS、VAS评分相比较，P > 0.05，无统计学差异。两组患者术后ASES、CMS、UCLA评分均比术前高，且双排组比单排组高，P < 0.05，比较存在统计学差异；两组患者术后OSS评分均比术前低，且双排组比单排组低，P < 0.05，比较存在统计学差异。两组患者术后VAS评分均比术前低，且双排组比单排组低，P > 0.05，比较不存在统计学差异。两组患者术后MRI肩袖完整情况均优于术前，且双排组优于单排组，P < 0.05，比较存在统计学差异。结论：肩关节镜下治疗巨大肩袖撕裂，在ASES、CMS、UCLA、OSS评分及MRI下肩袖完整情况方面说明双排缝合治疗相比于单排缝合效果更佳，但在VAS评分方面双排缝合治疗相比于单排缝合并无明显优势。

Abstract: Objective: To compare the clinical efficacy of arthroscopic single-row and double-row suture repair for massive rotator cuff tears. Methods: We collected 70 patients with massive rotator cuff tears at Qingdao Municipal Hospital who were admitted from July 2022 to January 2023. The patients were divided into a single row group and a double row group based on different surgical techniques, with 35 cases in each group. The single row group underwent arthroscopic single-row suture repair, while the double row group underwent arthroscopic double-row suture repair. The shoulder joint’s clinical functional recovery and the rotator cuff’s integrity on magnetic resonance imaging (MRI) were evaluated before surgery and six months after treatment. Results: There was no significant difference in ASES, CMS, UCLA, OSS, VAS scores, and MRI findings of rotator cuff integrity between the two groups before surgery (P > 0.05). After surgery, the ASES, CMS and UCLA scores were signif-icantly higher in both groups than before surgery, with the double row group showing higher scores than the single row group (P < 0.05). The OSS scores were significantly lower in both groups after surgery, with the double row group showing lower scores than the single row group (P < 0.05). The VAS scores were significantly lower in both groups after surgery, with no significant difference be-tween the double row and single row groups (P > 0.05). The MRI findings of rotator cuff integrity were better in both groups after surgery, with the double row group showing better results than the single row group (P < 0.05). Conclusion: Arthroscopic treatment of massive rotator cuff tears shows better results regarding ASES, CMS, UCLA, OSS scores, and MRI assessment when comparing dou-ble-row repair to single-row repair. However, regarding VAS scores, there is no significant ad-vantage of double-row repair over single-row repair.