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Objective To compare the early curative effects of arthroscopic modified suture bridge and single-row modified Mason-Allen suture in repair of supraspinatus tendon tears.Methods A retrospective case-control analysis was made on 28 patients with supraspinatus tendon tears admitted between June 2012 and June 2015.There were 16 males and 12 females,aged 43-63 years (mean,54.2 years).Thirteen patients (13 shoulders) were repaired using the arthroscopic modified suture bridge technique (Group A),and 15 patients (15 shoulders) were treated using the single-row modified Mason-Allen technique (Group B).Operation time and intraoperative blood loss were recorded.American shoulder and elbow surgeons (ASES) score,Constant score and visual analogue score (VAS) were used to evaluate the function and subjective outcomes preoperatively.Meanwhile,MRI was used for analysis of tendon integrity postoperatively.Results The operation time of Group A and B were (56.1 ± 23.2) minutes and (36.1 ± 15.6) minutes,respectively (P ＜ 0.05).The intraoperative blood loss was (30.3 ± 20.5) ml and (28.5 ± 18.2) ml,respectively (P ＞ 0.05).The average follow-up time for Groups A and B were 12 months and 12.6 months,respectively.The symptoms of 28 cases were alleviated after surgery,and the functions were obviously recovered.In Group A,thc VAS was decreased significantly from (7.0 ± 0.8) points preoperatively to (0.8 ± 0.8) points at final follow-up,ASES score was improved from (39.8 ± 3.1) points to (88.1 ± 4.8) points,and Constant score was improved from (54.8 ± 2.7) points to (88.2 ± 3.1) points (all P ＜ 0.05).In Group B,the VAS was decreased significantly from (6.8 ± 0.8) points preoperatively to (0.9 ± 0.8) points at final follow-up,ASES score was improved from (40.7 ± 2.5) points to (89.5 ± 3.2) points,and Constant score was improved from (56.0 ± 4.5) points to (89.3 ± 3.4) points (all P ＜ 0.05).There was no significant difference in the clinical outcomes between the two groups (P ＞ 0.05).The retear rate in Group B was 20％ (3/15),while no retear was presented in Group A (P ＜ 0.05).Conclusion Arthroscopic modified suture bridge technique and single-row modified Mason-Allen technique are both clinically effective for function recovery and pain relief in patients with supraspinatus tendon tears,but the former associated with lower incidence of tendon re-tear is preferred for moderate to large rotator cuff injury or rotator cuff injury with large insertion avulsion.
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Objective To investigate the clinical effects of arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation for treatment of moderate and severe patellofemoral osteoarthritis.Methods A retrospective case-control study was done on 80 patients with moderate to severe patellofemoral osteoarthritis who were treated in our hospital between March 2013 and March 2015.According to treatment methods,the patients were divided into two groups:Group A including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic debridement,and Group B including 40 cases (22 cases of Outerbridge grade Ⅲ degree and 18 cases of Outerbridge grade Ⅳ) undergone arthroscopic patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation.The Kujula scores and Lysholm scores of the patellofemoral joint were compared between the two groups before and after operation.The lateral patellofemoral angle was measured according to patellar axial X-ray performed 3 months after operation to evaluate patellofemoral joint function.Results All patients were followed up for 13-36 months (average 19.8 months).The patellofemoral joint scores of the two groups was increased at different degrees after operation.In moderate patellofemoral osteoarthritis patients,at 3 months after operation and the last follow-up of Group B,Kujula scores [(85.1 ± 6.8)points,(86.8 ± 4.6)points] and Lysholm scores [(88.1 ± 1.8) points,(88.4 ± 2.3) points] were higher than that of Group A [(78.1 ± 5.7) points,(78.3±5.3)points,(82.4 ±2.9)points,and (82.5 ±2.5)points] (P＜0.05).In each group,the Kujula scores and Lysholm scores at 3 months after operation and the last follow-up were improved to be higher than preoperation (P ＜ 0.05),with insignificant statistical difference between the two groups (P ＞ 0.05).According to the Lysholm scores,the excellent rate after operation in Group B (86％) was higher than that of Group A (55％) (P ＜ 0.05).For patients with severe patellofemoral osteoarthritis,Kujula scores [(72.3 ± 5.3) points,(72.7 ± 3.6) points] and Lysholm scores [(75.1 ± 1.9) points,(75.3 ± 2.3) points] at 3 months postoperatively and at the last follow-up in Group B were higher than that of Group A [(70.8 ± 5.2) points,(71.1 ± 4.2) points,(73.4 ± 2.8) points,and (73.6 ± 2.5) points],but the difference was not statistically significant (P ＞ 0.05).Within each group,although the Kujula scores and Lysholm scores at 3 months postoperatively and at the last follow-up were improved compared with before operation,but the difference was not statistically significant (P ＞ 0.05).According to the Lysholm scores,although the excellent rate after operation of Group B (33％) was higher than that of Group A (28％),with insignificant statistical difference (P ＞ 0.05).No matter Outerbridge Ⅲ or Ⅳ patellofemoral osteoarthritis a patient was,the lateral patellofemoral angle of Group A after operation had no significant improvement (P ＞ 0.05),while Group B showed significant improvement after operation (P ＜0.01).Group B had better improvements than that of Group A (P ＜0.01).Conclusions Compared with simple arthroscopic debridement,patelloplasty combined with lateral patellar retinaculum release and circumpatellar denervation can better relieve the symptoms of moderate patellofemoral osteoarthritis and improve knee function.But for patients with severe patellofemoral osteoarthritis,this method is not effective.
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BACKGROUND:There is a controversy in the clinical anterior cruciate ligament reconstruction using autologous hamstring tendon or tendon alograft. OBJECTIVE:To compare the clinical results of anterior cruciate ligament reconstruction with tendon alograft and autograft. METHODS: Totaly 123 patients with injured anterior cruciate ligament received anterior cruciate ligament reconstruction and they were divided into two groups: 63 cases in autograft group and 60 cases in alograft group. The postoperative effects were assessed by the Lysholm score and Lachman test. RESULTS AND CONCLUSION: Al the patients were folowed for more than 8 months. After anterior cruciate ligament reconstruction, the stability of the knee joint, Lysholm scores and Lachman test results were al improved significantly in the two groups; while there was no difference between the two groups at the last folow-up (P > 0.05). The clinical outcomes of anterior cruciate ligament reconstruction with alograft and autograft are almost similar; therefore, surgeons should select ideal graft according to the patient’s condition and surgeon’s experience.