[1]夏新成 吴战坡 李群 包先国 丁祖运.关节镜下保留残端修补对肩袖损伤术后肩关节功能及腱-骨界面愈合的影响[J].中国中医骨伤科杂志,2026,34(05):68-77.[doi:10.20085/j.cnki.issn1005-0205.260510]
　XIA Xincheng,WU Zhanpo,LI Qun,et al.The Effect of Arthroscopic Residual Tissue Repair on Shoulder Joint Function and Tendon-Bone Interface Healing after Rotator Cuff Repair Surgery[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(05):68-77.[doi:10.20085/j.cnki.issn1005-0205.260510]
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关节镜下保留残端修补对肩袖损伤术后肩关节功能及腱-骨界面愈合的影响()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第34卷
期数:
2026年05期
页码:
68-77
栏目:
临床研究
出版日期:
2026-05-10

文章信息/Info

Title:
The Effect of Arthroscopic Residual Tissue Repair on Shoulder Joint Function and Tendon-Bone Interface Healing after Rotator Cuff Repair Surgery
文章编号:
1005-0205(2026)05-0068-10
作者:
夏新成 吴战坡 李群 包先国 丁祖运
1南京市溧水区人民医院(南京,211200)
Author(s):
XIA Xincheng1; WU Zhanpo1; LI Qun1; BAO Xianguo1; DING Zuyun1△
1Nanjing Lishui People's Hospital,Nanjing 211200,China.
关键词:
保留残端修补技术;  足印区肩袖残端;  肩袖损伤;  肩关节;  腱-骨界面愈合
Keywords:
remnant-preserving repair technique;  remnant rotator cuff in the footprint area;  rotator cuff injuries;  shoulder joint;  tendon-bone healing
分类号:
R684.3
DOI:
10.20085/j.cnki.issn1005-0205.260510
文献标志码:
A
摘要:
目的:分析关节镜下肩袖足印区保留残端修补技术对肩袖损伤术后肩关节功能及腱-骨界面愈合模式的影响。方法:纳入2023年1月至2024年1月收治的158例肩袖损伤患者,其中79例行关节镜下肩袖足印区保留残端修补术(观察组),79例行关节镜下肩袖足印区去除残端修补术(对照组)。比较两组患者术前、术后3个月及12个月时肩关节活动度(前屈上举、外展上举、体侧外旋、外展内旋)、外展肌力比值、美国肩肘外科协会(ASES)评分、Constant-Murley评分、疼痛视觉模拟量表(VAS)评分; 比较两组患者术前及术后12个月时骨隧道扩大程度、移植物腱-骨节点T2值; 比较术后12个月时两组患者Sugaya分型; 随访期间记录患者术后并发症。结果:重复测量方差分析结果显示,两组患者的肩关节活动度、外展肌力比值的时间效应、组间效应和交互效应差异有统计学意义(P<0.05); 观察组患者与对照组患者肩关节活动度、外展肌力比值水平随时间变化趋势不同; 观察组患者术后3个月及12个月的肩关节活动度、外展肌力比值均优于对照组,差异均有统计学意义(P<0.05)。广义估计方程(GEE)模型分析显示,Constant-Murley评分、ASES评分和疼痛VAS评分在组别、时间及二者交互项中差异有统计学意义(P<0.05)。术后12个月时观察组患者骨隧道扩大程度大于对照组[(2.26±0.24)mm vs(1.07±0.13)mm],移植物腱-骨结点T2值小于对照组[(54.08±10.23)ms vs(117.52±12.37)ms],差异有统计学意义(P<0.05)。两组患者肩袖愈合Sugaya分型差异有统计学意义(P<0.05)。两组患者均未出现并发症。结论:关节镜下保留残端修补技术通过保留生物活性残端组织,契合“筋骨并重”的中西医结合修复理念,可显著改善肩袖损伤患者的肩关节功能,减轻疼痛,优化腱-骨界面愈合质量,降低再撕裂风险。该术式生物学优势与中医“筋骨并重”“以筋养筋”的修复理念相契合,可为探索中西医结合康复方案提供现代解剖学与生物力学基础。
Abstract:
Objective:This study evaluates the effects of arthroscopic footprint-preserving surgical techniques in rotator cuff reconstruction.The primary focus centers on postoperative functional recovery and tendon-bone interface healing patterns at the tendon-bone interface.Methods:A total of 158 patients with rotator cuff tears treated between January 2023 to January 2024 were enrolled.Seventy-nine patients underwent arthroscopic footprint-retaining rotator cuff repair(observation group),while 79 others underwent arthroscopic footprint-debridement rotator cuff repair(control group).Comparisons were made between the two groups regarding shoulder range of motion(forward flexion,abduction,external rotation at the side,and internal rotation in abduction),abduction strength ratio,American shoulder and elbow surgeons(ASES)score,Constant-Murley score,and pain visual analogue scale(VAS)score-assessed preoperatively and at 3 and 12 months postoperatively.Bone tunnel enlargement and T2 values at the graft tendon-bone interface were compared preoperatively and at 12 months postoperatively.MRI was performed at 12 months to assess tendon healing using the Sugaya classification system.Postoperative complications were recorded during follow-up.Results:Repeated-measures ANOVA revealed statistically significant main effects of time and group,as well as a significant time and group interaction effect,on shoulder range of motion and the abduction strength ratio(all P<0.05).The observation group showed significantly greater shoulder range of motion and a higher abduction strength ratio than the control group at both 3 months and 12 months postoperatively(P<0.05).The analysis using the generalized estimating equation(GEE)model revealed that the Constant-Murley score,the ASES score,and the pain VAS score showed statistically significant differences among groups,over time,and in their interaction terms(P<0.05).At 12 months postoperatively,the degree of bone tunnel enlargement in the observation group was greater than that in the control group((2.26±0.24)mm vs(1.07±0.13)mm),and the T2 value at the graft tendon-bone junction was significantly lower in the observation group than that in the control group((54.08±10.23)ms vs(117.52±12.37)ms)(P<0.05).Sugaya classification system of tendon healing significantly favored the observation group(P<0.05).No complications occurred in either group.Conclusion:The arthroscopic residual tissue preservation and repair technique,by retaining the biologically active residual tissue,aligns with the combined traditional Chinese and Western medicine concept of “equal emphasis on tendons and bones”,significantly improving the shoulder joint function of patients with rotator cuff injuries,reducing pain,optimizing the healing quality of the tendon-bone interface,and lowering the risk of re-tear.This surgical method's biological advantages align with the traditional Chinese medicine concept of “equal emphasis on tendons and bones” and “nourishing tendons with tendons”,providing a modern anatomical and biomechanical foundation for exploring combined traditional Chinese and Western medicine rehabilitation plans.

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(收稿日期:2025-04-09)

备注/Memo

备注/Memo:
基金项目:2021年东南大学附属中大医院溧水分院院级课题(LY2021010)
△通信作者 E-mail:68119087@qq.com
更新日期/Last Update: 2026-05-15