关键词: 肩袖损伤, 关节镜, 双镜联合, 铆钉固定, 功能恢复

Abstract: Objective To compare the efficacy,safety and effects on postoperative inflammation,shoulder function and complications of dual-endoscope combined (arthroscopy + mini-incision) and conventional arthroscopic rivet fixation for rotator cuff injury.Methods Ninety patients (Jan 2023-Jan 2025) were prospectively randomized into two groups (n=45 each).The control group received conventional arthroscopic rivet fixation,and the observation group received dual-endoscope combined fixation.The levels of serum inflammatory factors,shoulder joint range of motion,shoulder joint function-related scores(UCLA,ASES,CMS),supraspinatus muscle occupancy rate and the occurrence of complications were compared between the two groups of patients before treatment (preoperative) and after treatment (6 months after surgery).Results The levels of serum tumor necrosis factor (TNF)-α,C-reactive protein (CRP),interleukin (IL)-6,and IL-8 in the observation group were(17.32±3.16)ng/ml,(13.27±2.49)mg/L,(12.06±3.48)H/L and (10.47±3.12)ng/L,respectively,which were all lower than those in the control group [(21.06±3.94)ng/ml,(19.06±3.17)mg/L,(20.16±4.92)H/L,and (15.32±2.49)ng/L],with statistically significant differences between the two groups (P<0.05).After treatment,the ranges of shoulder joint forward flexion,backward extension,external rotation,and abduction in the observation group were (147.32±16.94)°,(39.86±3.15)°,(49.35±4.32)°,and(119.58±19.45)°,respectively,which were all higher than those in the control group[(129.48±15.23)°,(34.16±4.35)°,(41.64±5.11)°,and(101.49±21.58)°],with statistically significant differences between the two groups (P <0.05).After treatment,the pain score,function score,active forward flexion score,forward flexion strength score,and subjective satisfaction score in the UCLA score of the observation group were (5.97±1.02),(6.01+1.03),(4.77+0.94),(3.12±0.56),and(3.65±0.65),respectively,which were all higher than those in the control group [(4.99±1.07),(5.16±1.08),(3.73±0.65),(2.56±0.42),and (3.09±0.58)],with statistically significant differences between the two groups (P<0.05).After treatment,the ASES score of the observation group was (14.46±1.28),which was higher than (13.16± 1.58) in the control group,with a statistically significant difference between the two groups (P<0.05).After treatment,the pain,muscle strength,activities of daily living,and limb mobility scores in the CMS of the observation group were (12.23±1.16),(24.05±3.44),(16.88±2.05),and(27.77±3.94),respectively,which were all higher than those in the control group [(10.12±1.06),(19.04±3.11),(13.36±1.65),and (23.76±3.15)],with statistically significant differences between the two groups (P <0.05).After treatment,the occupation rate of the supraspinatus muscle in the observation group was higher than (78.65±10.15)% in the control group (P <0.05).The incidence of complications in the observation group was 8.89%,which was lower than 24.44% in the control group,with a statistically significant difference between the two groups(P<0.05).Conclusion Dual-endoscope combined fixation for rotator cuff injury reduces postoperative inflammation,improves shoulder function and supraspinatus occupation rate,lowers complications,and has better medium-term efficacy than conventional arthroscopic rivet fixation.

Key words: rotator cuff injury, arthroscopy, dual-endoscope combination, rivet fixation, functional recovery