Clinical outcome of arthroscopic capsular release for frozen shoulder: essential technical points in 255 patients.
Clinical outcome of arthroscopic capsular release for frozen shoulder: essential technical points in 255 patients.
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DOI：
10.1186/s13018-018-0758-5
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发表时间：
2018-03-16
影响因子：
2.6
通讯作者：
Kanbe K
中科院分区：
文献类型：
--
作者：
Kanbe K
本研究的目的是探讨255例肩关节镜下带技术点肩关节囊松解术后二头长头（LHB） CH韧带粘连严重程度的长期临床结果及其相关因素。我们对255例患者进行关节镜下肩关节囊松解术，共267例肩关节，男112例，女143例，平均年龄56.39岁，保守治疗平均病程0.934年，平均随访5.6年。根据LHB上CH韧带间粘连的严重程度划分冻结肩：轻度滑膜炎，无钝棒粘连，松脱囊厚度轻微者（A型）；中度滑膜炎，钝棒粘连LHB中度，松脱囊厚度适中者（B型）；重度滑膜炎，钝棒粘连LHB严重，松脱囊厚度严重粘连LHB扁平者（C型）。我们根据美国肩关节外科医生（ASES）的标准评估与肩部评分相关的临床因素以及与LHB粘连严重程度的关系。术后5年，三组患者的as评分均显著提高。三组患者的活动范围也明显改善。证实LHB粘附在CH韧带上的严重程度影响关节镜下囊膜释放前后的ASES评分。术前、术后a型与B型（p < 0.0001）、C型（p < 0.0001）差异有统计学意义。Logistic回归分析显示，病程、糖尿病（DM）、ASES评分与LHB严重程度类型显著相关，其中DM具有较高的比值比，是LHB粘连的危险因素。术后5年无脱位或腋窝神经损伤及关节镜下松解囊后复发等不良事件发生。在255例患者中证实了关节镜下肩关节囊松解术的长期疗效。LHB粘附在CH韧带上的严重程度，是一种与DM相关的病理状况，是一种危险因素，似乎在功能结果中起着重要作用。因此，充分释放LHB是关节镜下肩关节囊释放术的关键技术要点。
The purpose of this study was to investigate the long-term clinical outcome and its related factors regarding the severity of adhesion of CH ligament over long head of biceps (LHB) after shoulder arthroscopic capsular release for frozen shoulder with technical points in 255 patients. We performed arthroscopic capsular release for frozen shoulder in 267 shoulders of 255 patients, 112 males and 143 females, with mean age of 56.39 years, mean disease duration periods of 0.934 years for conservative treatment, and mean follow-up periods of 5.6 years. The frozen shoulders were divided based on the severity of adhesion between CH ligament over LHB: those with slight degree of synovitis, no adhesion by obtuse rod, and slight thickness of the released capsule (type A), those with moderate degree of synovitis, moderate adhesion of the LHB by obtuse rod, and moderate thickness of the released capsule (type B), and those with severe degree of synovitis, severe adhesion of the LHB by obtuse rod, and severe thickness of the released capsule adhesion and a flatly shaped LHB (type C). We assessed the clinical factors related to the scoring of the shoulders by the criteria of the American Shoulder and Elbow Surgeons (ASES) and the relationship with severity of LHB adhesion. The ASES scores improved at 5 years postoperatively in all three groups significantly. The range of motion also significantly improved in all three groups significantly. The severity of the LHB adhesion over the CH ligament was confirmed to influence the ASES scores before and after the arthroscopic capsular release. There was a significant difference between type A and type B (p < 0.0001) or type C (p < 0.0001) before and after surgery. Logistic regression analysis showed disease duration, diabetes mellitus (DM), and ASES score were significantly associated to the severity type of LHB, especially DM has high odds ratio and was a risk factor for LHB adhesion. There is no adverse event including dislocation or axillary nerve injury and recurrence after arthroscopic capsular release at 5 years after surgery. The long-term results of arthroscopic capsular release in frozen shoulder were confirmed in 255 patients. The severity of LHB adhesion over the CH ligament, a pathological condition related to DM as a risk factor, seems to play an important role in the functional outcome. Therefore, the sufficient release of LHB was essential technical point for arthroscopic capsular release in frozen shoulder.
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影响因子：
3
作者：
Arai, Ryuzo;Nimura, Akimoto;Akita, Keiichi
通讯作者：
Akita, Keiichi
影响因子：
5.3
作者：
Le Lievre, Hugh M. J.;Murrell, George A. C.
通讯作者：
Murrell, George A. C.
DOI：
10.1002/art.22892
发表时间：
2007-08-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Buchbinder, Rachelle;Youd, Joanne M.;Wright, Warwick J. L.
通讯作者：
Wright, Warwick J. L.
影响因子：
3
作者：
Michener, LA;McClure, PW;Sennett, BJ
通讯作者：
Sennett, BJ
DOI：
10.5604/15093492.1143530
发表时间：
2015-01-01
期刊：
Ortopedia, traumatologia, rehabilitacja
影响因子：
--
作者：
Mubark, Islam M;Ragab, Abdelaleem H;Motawea, Bahaa A
通讯作者：
Motawea, Bahaa A