Objective To compare the clinical efficacy of arthroscopic debridement, transtendon repair and tear completion and repair in treating Ellman II partial articular surface tendon avulsions. Methods A retrospective case control study was conducted on 45 patients with partial articular surface tendon avulsions admitted to East Division of Shanghai Sixth Hospital Affiliated to Shanghai Jiao Tong University from December 2017 through December 2019. There were 18 males and 27 females, with a mean age of (56.4±5.0)years (range, 3866 years). The patients were assigned to arthroscopic debridement group (n=15), arthroscopic transtendon repair group (n=15), and arthroscopic tear completion and repair group (n=15). Operation time and complications were recorded. American Shoulder and Elbow Surgeons (ASES) score and University of California, Los Angeles (UCLA) score were measured preoperatively, at postoperative 3 months and at the latest follow-up. Results All the patients were followed up for 832 months [(18.2±6.3)months]. In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the operation time was (43.7±3.1)minutes, (89.1±5.4)minutes, (62.2±3.6)minutes, respectively (P<0.05). No complications such as nerve injury, infection and arthrofibrosis were observed after operation. In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score was preoperative (48.7±2.9)points, (49.1±3.0)points, (48.3±3.6)points, respectively (P>0.05); the UCLA score was preoperative (15.5±1.3)points, (15.4±1.8)points, (15.2±1.4)points, respectively (P>0.05). In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score at the latest followup was (90.1±1.6)points, (89.3±1.0)points, (89.4±1.0)points, respectively (P>0.05); the UCLA score at the latest followup was (30.3±2.1)points, (29.0±2.3)points, (28.9±2.7)points, respectively(P>0.05). In arthroscopic debridement group, arthroscopic transtendon repair group and arthroscopic tear completion and repair group, the ASES score at postoperative 3 months was (84.4±2.3)points, (73.5±3.6)points, (73.6±3.2)points, respectively; the UCLA score at postoperative 3 months was (26.9±1.4)points, (21.4±1.0)points, (21.1±1.0)points, respectively. In comparison, no significant difference was found between arthroscopic transtendon group and arthroscopic tear completion and repair group (P>0.05). However, ASES score and UCLA score in arthroscopic debridement group were significantly higher than those in arthroscopic transtendon group and arthroscopic tear completion and repair group (P<0.05). Conclusions Arthroscopic debridement, transtendon repair and tear completion and repair are effective techniques for treatment of Ellman II partial articular surface tendon avulsions. However, the operation time and early efficacy of arthroscopic debridement are better than other two techniques.
蒋仕林 袁锋 邱勇嘉 赵金忠 王锋 陆叶 涂兵. 三种关节镜手术方式治疗EllmanⅡ级关节侧部分肩袖损伤的疗效比较[J]. 中华创伤杂志, 2020, 36(9): 779-784.
Jiang Shilin, Yuan Feng, Qiu Yongjia, Zhao Jinzhong, Wang Feng, Lu Ye, Tu Bin.. Efficacy comparison of three different arthroscopic techniques in treating Ellman Ⅱ partial articular surface tendon avulsions. CHINESE JOURNAL OF TRAUMA, 2020, 36(9): 779-784.