A Comparative Study Of Full-shoulder Arthroscopy And Arthroscopic-assisted Surgery In The Treatment Of Small And Medium Rotator Cuff Injury

Objective:Shoulder cuff injuries accounted for 17 to 40%of shoulder joint disease,of which the incidence is increasing year by year over the age of 40^[1].The traditional open operation for the treatment of rotator cuff injury is rarely used because of severe surgical trauma^[2]and postoperative joint adhesion.Arthroscopy is a smaller incision in the treatment of rotator cuff injury,but the operation is more complicated and the operation is more difficult.The aim of this study is to make a retrospective analysis of the above two operations in the Department of orthopaedic surgery in our hospital,aiming to compare the effects of the two kinds of operations,so as to provide references for clinical practice.Methods:A retrospective analysis was performed in 42 patients admitted to our hospital from January 2012 to January 2017.In these cases,the patients were diagnosed as rupture of supraspinatus tendon before operation by MRI,excluding the massive rotator cuff injury（tear area 3-5cm or multiple rotator cuff tears）.The age range from 28 to 65 years（including 65 years）,and the follow-up time was at least 12 months.They were randomly divided into full-shoulder and arthroscopy-assisted group,with 20 cases in the two groups.All operations were performed by the same senior physician.It is necessary to accurately record the time and procedure of the operation.The UCLA score,VAS score and ASES score were used to evaluate the shoulder function,mobility,pain,muscle strength and subjective feelings and postoperative complications of the two groups.The follow-up results were recorded at 3,6,12,half,and 1 years after the operation.All the statistical data were recorded as x±s（mean standard deviation）,using paired t test,independent sample t test,chi square test and so on.SPSS 19 software was used for statistical analysis to compare the clinical efficacy of the two groups.Results:All patients were followed up effectively.From the statistical results,the two groups were obviously improved after operation.The score of full-shoulder arthroscopy group in3 and 6 weeks was better that of the arthroscopic-assisted group,which was statistically significant（P<0.05）.In the subsequent statistics,the statistical results of the two groups gradually tended to be consistent,and there was no significant statistical difference（P>0.05）.Conclusion:1.Two kinds of surgical methods can achieve satisfactory results.There was no significant difference in the function and sensation of the affected limbs after operation in all the cases.2.The early effect of full-shoulder arthroscopy was slightly better than the arthroscopy assisted group.In the long run,there was no significant difference between the two groups.3.Arthroscopic-assisted operation with small incision is less invasive,while the full-shoulder arthroscopy is less difficult to operate,and it is more suitable for the beginners of primary learning.The total arthroscope group has longer operation time and more difficult operation.It is suitable for the skillful people with arthroscopy,and it does not apply to patients with poor tolerance.The operator should choose the appropriate surgical procedure after weighing the advantages and disadvantages of all the parties.