老年人巨大肩袖撕裂的关节镜治疗进展

Arthroscopic repair of massive rotator cuff tear in the elderly: a progress

摘要:

巨大肩袖撕裂在老年人群中发病率高，可引起肩关节疼痛和功能障碍，严重影响患者生活质量。肩袖撕裂通常伴随肌腱回缩、变性，肌肉萎缩、脂肪浸润，且老年人骨质疏松严重，使修复更加困难，术后再撕裂率高。本文对清理减压、完全修复术、部分修复术、补片修复和上关节囊重建治疗巨大肩袖撕裂疗效和预后的最新进展做一综述，为外科医师的临床决策提供理论支撑。

Abstract:

The incidence of massive rotator cuff tear is quite high in the elderly patients. It can result in pain and shoulder dysfunction, and reduce their quality of life greatly. Massive rotator cuff tear usually accompanies with tendon retraction, degeneration, muscle atrophy, and fat infiltration. What’s more, because the elderly patients commonly have severe osteoporosis, it further makes the repair more difficult and with high post-operative tear rate. The article reviewed the recent progress on the clinical efficacy and prognosis of 5 surgical strategies in the treatment, that is, debridement and decompression, complete repair, partial repair, patch repair and reconstruction of shoulder joint capsule, in order to provide theoretical foundation for the surgeon’s decision making.