Comparison Of Two Surgical Methods In The Treatment Of Rotator Cuff Tendinopathy

Objective: Objective To compare the effect of whether the rotator cuff pathological tissue cleaning and tendon insertion reconstruction or not under shoulder arthroscopy on the surgical treatment of rotator cuff tendinopathy.Methods: The clinical data of 41 patients with rotator cuff tendinopathy treated by surgical medicine ward in Shengjing Hospital of China Medical Universityl from September 2015 to January 2017 were analyzed retrospectively.According to different surgical methods were divided into A group and B group.Patient of group A was given shoulder arthroscopy of the bursa to clear and selective shoulder acromioplasty.Patient of group B was given cleanup of pathological changes tissue and reconstruction of tendon insertion on the basis of A.All patients were followed up for one year.Patients were evaluated by three kinds of shoulder function score including Constant-Murley score,Visual analog score(VAS)and University of California Los angelas score(UCLA)as well as three kinds of physical examination including Hawkins sign,painful arc sign and infraspinatus test.To compare the therapeutic differences by two surgical methods to cure rotator cuff tendinopathy.Results: Compared with the preoperative,the postoperative VAS score,UCLA score and Constant-Murley score in both groups were significantly improved.In group A,the postoperative 0.7 ± 0.4,33.0 ± 1.7 and 90.9 ± 3.1 points were achieved by preoperative 5.0 ± 1.3,15.5 ± 1.4 and 65.1 ± 5.7 points respectively.In group B,the postoperative 0.4±0.5,34.3±0.9,93.3±2.3 points were achieved by preoperative 5.2±1.0,15.6±2.0,65.4±5.9 points respectively.Differences were statistically significant(Group A t = 14.77,P <0.001;t =-74.44,P <0.001;t =-29.19,P <0.001;group B t = 23.13,P <0.001;t =-61.52,P <0.001;t =-26.38,P <0.001).Among them,the postoperative statistics of UCLA score and Constant-Murley score of shoulder joint in group B were higher than those in group A.The differences were statistically significant(t =-3.27,P = 0.003;t =-2.90,P = 0.007).The positive rate of postoperative Hawkins sign,painful arc sign and infraspinatus test showed as follows.A group was preoperative 90%(18/20),90%(18/20),95%(19/20)decreased to postoperative 15%(3/20),10%(2/20),15%(3/20).Preoperative and postoperative differences were statistically significant(c2= 13.067,P <0.001;c2 = 14.063,P <0.001;c2 = 14.063,P <0.001);.B group was preoperative 90.5%(19/21),85.6%(18/21),90.5%(19/21)decreased to postoperative 9.5%(2/21),4.8%(1/21),9.5%(2/21).Preoperative and postoperative differences were statistically significant(c2 = 15.059,P <0.001;c2= 12.500,P <0.001;c2= 15.059,P <0.001).Conclusion: Both A group and B group are efficient to cure rotator cuff tendinopathy,and group B has better clinical efficacy than group A.