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Objective:To investigate the mid-term clinical outcomes of arthroscopic vertical mattress suturing for shoulder recurrent anterior dislocation combined with joint laxity.Methods:A retrospective case series study was performed on the clinical data of 11 patients with recurrent anterior shoulder dislocation combined with joint laxity admitted to the First Affiliated Hospital, Army Medical University from January 2018 to September 2021. The patients included 10 males and 1 female, aged 18-38 years [(22.8±5.5)years]. All the patients received treatment with arthroscopic vertical mattress suturing. The Oxford shoulder instability score, Rowe shoulder instability score, and simple shoulder test (SST) score were compared before operation, at 6 months after operation and at the final follow-up. The degree of joint capsule laxity and length of capsular redundancy (evaluated by MRI) were compared before operation and at the final follow-up. The results of the supine apprehension test, re-dislocation and postoperative complications such as iatrogenic vascular and nerve injuries were observed at the final follow-up. Also, the correlation between the radiological changes in the joint capsule and the shoulder function was analyzed by Spearman correlation coefficient.Results:All the patients were followed up for 20-64 months [(40.7±18.6)months]. Before operation, at 6 months after surgery and at the final follow-up, the values of Oxford shoulder instability score were (41.2±4.7)points, (49.5±3.0)points and (57.6±3.0)points; the values of Rowe shoulder instability score were (28.6±9.5)points, (77.7±7.2)points and (94.1±10.9)points; and the values of SST score were (7.6±1.3)points, (9.8±1.0)points and (11.6±0.9)points, respectively. The Oxford shoulder instability score, Rowe shoulder instability score and SST at 6 months after operation and at the final follow-up were significantly better than those before operation, and those at the final follow-up were significantly better than those at 6 months after operation (all P<0.05). The MRI showed that the degree of joint capsular laxity and length of capsular redundancy were 1.5±0.2 and (19.7±2.5)mm before operation and were 1.3±0.2 and (12.9±3.7)mm at the final follow-up, respectively ( P<0.05 or 0.01). The supine apprehension test was negative at the final follow-up, with no re-dislocation or postoperative complications such as iatrogenic vascular or nerve injuries. Correlation analysis showed a negative correlation between the degree of joint capsular laxity and the Oxford shoulder instability score ( r=-0.62, P<0.05) and that of the length of capsular redundancy with the Oxford shoulder instability score ( r=-0.80, P<0.01), the Rowe shoulder stability score ( r=-0.73, P<0.01) and the SST score ( r=-0.75, P<0.01). Conclusions:Arthroscopic vertical mattress suturing has good mid-term clinical outcome for recurrent shoulder anterior dislocation combined with joint laxity, improving the shoulder function and reducing complications, wihch is associated with decreased joint capsule laxity and length of capsular redundancy.
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Objective To investigate the altered lipid in systemic sclerosis(SSc),and the relationship between the altered lipid and inflammation.Methods A total of 58 SSc patients were recruited into SSc group,and 58 healthy persons were recruited into control group from 2012 to 2014.Triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-c)and high density lipoprotein-cholesterol(HDL-c),lipoprotein a[LP(a)],C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR) were assessed using standard techniques in all cases,antinuclear antibody(ANA)and anti-Scl-70 antibody were assessed only in SSc patients.The levels of lipids between SSc patients and healthy controls,patients with antibody and patients without antibody were compared by using t test,corrections between lipid and inflammation were analyzed by Spearman′s correlation test.Results The clinical manifestations of SSc were mostly Raynaud′s phenomenon(91.4%),large area of black hard shin(87.9%),gastrointestinal manifestations(75.9%).The rates of an increased level of TG and decreased level of HDL-c were 29.3%,89.7% respectively.The level of TG in SSc was significant higher than in healthy controls(P =0.021),and the level of HDL-c in SSc was significant lower than in healthy controls(P =0.033).The levels of lipids in patients with ANA and anti-Scl-70 antibody had no significant difference with the patients without ANA and anti-Scl-70 antibody (P >0.05 ).Spearman′s correlation test demonstrated that HDL-c level correlated negatively with serum CRP (r=-0.285,P =0.039)and ESR (r =-0.271,P =0.043)in SSc.Conclusion Dyslipi-demia is a common feature in SSc patients that are characterized by an increase in TG and a decrease in HDL-c,inflammation might partly account for the changes.