背景:确定基于射频的等离子微肌腱切开术在治疗肩袖肌腱畸形的肩关节撞击综合征中是否具有积极的疗效。
方法:本研究纳入了80例经关节镜治疗的撞击综合征和袖带肌腱病患者。患者被随机分配接受关节镜下肩峰下减压术(ASD组,n=40)或关节镜下肩峰下减压联合射频(RF)等离子微张力切开术(RF组,n=40)。临床结果数据,包括VAS疼痛评分,肩部运动范围(ROM),ASES,加州大学洛杉矶分校,Constant-Murley,术前和术后3周记录SST评分,6周,3个月,6个月,术后1年。
结果:80例患者中有65例(81.3%)可在术后1年进行最后随访。ASD组32例,RF组33例。两组患者术后3周疼痛均显著减轻(ASD组P=0.031vsRF组P=0.017)。两组患者术后3个月功能评分均有明显改善。两个治疗组术后1年的屈曲抬高(FE)和外旋转(ER)以及术后6个月的内旋转(IR)显着改善。在术后任何时间点的任何结果测量中,两组之间均未发现显着差异。
结论:关节镜下肩峰下减压术是治疗难治性撞击综合征的可靠方法。额外的基于射频的等离子微肌腱切开术未显示任何关于疼痛缓解的显著积极效果。ROM,或功能恢复。
BACKGROUND: To determine whether radiofrequency based plasma microtenotomy has a positive effective in the treatment of shoulder impingement syndrome with cuff tendinosis.
METHODS: Eighty patients with impingement syndrome and cuff tendinosis that were treated arthroscopically were enrolled in the study. The patients were randomly assigned to receive either arthroscopic subacromial decompression (ASD) alone (ASD group, n = 40) or arthroscopic subacromial decompression combined with radiofrequency (RF) based plasma microtenotomy (RF group, n = 40). Clinical outcome data including VAS pain score, shoulder range of motion (ROM), ASES, UCLA, Constant-Murley, and SST score were recorded preoperatively and at 3 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively.
RESULTS: Sixty-five out of eighty patients (81.3%) were available for the final follow-up at 1 year postoperation. There were 32 patients in the ASD group and 33 in the RF group. Both treatment groups showed significantly (P = .031 in the ASD group vs P = .017 in the RF group) reduced pain 3 weeks postoperatively. Both treatment groups showed significantly improved functional scores 3 months postoperatively. Both treatment groups showed significantly improved flexion elevation (FE) and external rotation (ER) 1 year postoperatively and internal rotation (IR) 6 months postoperatively. No significant difference between the 2 groups was found in any of the outcome measurements at any time point postoperatively.
CONCLUSIONS: Arthroscopic subacromial decompression is a reliable treatment for refractory impingement syndrome. The additional radiofrequency based plasma microtenotomy did not show any significant positive effects regarding pain relief, ROM, or functional recovery.