Voos James E, Pearle Andrew D, Mattern Christopher J, Cordasco Frank A, Allen Answorth A, Warren Russell F
Shoulder and Sports Medicine Service, Hospital for Special Surgery, New York, NY 10021, USA.
Am J Sports Med. 2007 Jul;35(7):1174-9. doi: 10.1177/0363546507300062. Epub 2007 Mar 26.
Rotator cuff tears, Bankart lesions, and superior labral anterior posterior lesions commonly occur in isolation, but there is a subgroup of patients who experience combined injuries. Prior studies have excluded such patients as confounding groups.
In patients with combined lesions of the labrum and rotator cuff, arthroscopic repair of both lesions will restore range of motion and stability and provide good clinical results.
Cohort study; Level of evidence, 3.
We retrospectively evaluated the clinical outcomes of a series of patients with combined rotator cuff and labral (Bankart or superior labral anterior posterior) lesions treated arthroscopically.
Thirty patients (average age, 47.8 years) with combined rotator cuff and labral lesions were evaluated at a mean follow-up of 2.7 years (range, 24-54 months). Sixteen patients had Bankart lesions and 14 patients had SLAP lesions. Significant improvements in forward flexion (20.5 degrees, P = .005), external rotation (9.0 degrees, P = .008), and internal rotation (2 vertebral levels, P = .016) were observed. The mean L'Insalata and American Society of Shoulder and Elbow Surgeons scores for all patients were 92.9 and 94.3, respectively. Twenty-seven (90%) patients reported satisfaction as good to excellent, and 23 of 30 (77%) returned to their preinjury level of athletics. Two patients suffered recurrent rotator cuff tears.
In patients with rotator cuff and labral lesions, arthroscopic treatment of both lesions yields good clinical outcomes, restoration of motion, and a high degree of patient satisfaction.
肩袖撕裂、Bankart损伤和上盂唇前向后方损伤(SLAP损伤)通常单独发生,但有一小部分患者会出现合并损伤。既往研究已将这类患者排除在混杂组之外。
对于合并盂唇和肩袖损伤的患者,关节镜下修复这两种损伤将恢复活动范围和稳定性,并带来良好的临床效果。
队列研究;证据等级,3级。
我们回顾性评估了一系列经关节镜治疗的合并肩袖和盂唇(Bankart损伤或SLAP损伤)损伤患者的临床结果。
对30例(平均年龄47.8岁)合并肩袖和盂唇损伤的患者进行了评估,平均随访2.7年(范围24 - 54个月)。16例患者为Bankart损伤,14例患者为SLAP损伤。观察到前屈(20.5度,P = .005)、外旋(9.0度,P = .008)和内旋(2个椎体节段,P = .016)有显著改善。所有患者的平均L'Insalata评分和美国肩肘外科医师学会(ASES)评分分别为92.9分和94.3分。27例(90%)患者报告满意度为良好至优秀,30例中有23例(77%)恢复到伤前的运动水平。2例患者出现复发性肩袖撕裂。
对于合并肩袖和盂唇损伤的患者,关节镜下治疗这两种损伤可产生良好的临床效果、恢复活动度并获得高度的患者满意度。