探讨肩关节镜下"中国结"缝合技术治疗肩胛下肌腱撕裂的早期疗效。

回顾性分析本院2018年2月至2019年1月21例采用"中国结"缝合技术治疗肩胛下肌腱损伤的病例。分别于术前及术后3、6、12个月采用美国加州大学肩关节评分系统（University of California at Los Angeles，UCLA）评分和Constant评分系统进行疗效评价。术前、术后1年均行肩关节MRI检查评估肩胛下肌腱的情况。

随访时间12~15个月，平均（13.2±3.8）个月。UCLA肩关节评分由术前（9.78±1.88）分，增加至术后1年随访时的（29.44±2.56）分；Constant评分由术前（31.34±3.89）分增加至术后1年随访时的（78.97±5.84）分;两项指标差异均有统计学意义（P< 0. 01） 。MacNab优良率术后1年随访时为90. 47%。Bear Hug test（+） 、Belly press test（+）患者例数在术后呈现显著性下降，所有21例患者均于随访期观察到肩胛下肌腱连续的MRI影像,未发生血管损伤、神经损伤、锚钉拔出、感染等并发症。

"中国结"缝合技术在镜下治疗肩胛下肌腱损伤具有简单、快捷的特点，临床效果可靠。

In recent years, arthroscopic surgery has been widely used in the treatment of rotator cuff injury. Arthroscopic surgery for the treatment of subscapularis tendon tears has more difficulties and challenges when compared with that for supraspinatus or infraspinatus tendon tears. Most of the subscapularis tendon tears are related to degeneration, and the tendon quality is poor. At present, many improved suture methods were invented for the repair, but the operation is difficult. Different suture and fixation techniques have their own advantages and disadvantages. How to make the operation more simple and reduce the retear rate after operation is an urgent problem to be solved. Objective To investigate the early curative efficacy of "Chinese knot" suture technique for treatment of subscapularis tendon tears under shoulder arthroscopy.

Twenty-one cases of subscapularis tendon tears were treated with "Chinese knot" suture technique from February 2018 to January 2019. The Bear Hug test, Belly press test, UCLA scores and Constant-Murley score were recorded before operation and in the 3rd month, 6th month and 12th month after operation, and they were used to evaluate the clinical efficacy. The Shoulder joint MRI examination was performed before operation and 1 year after operation to evaluate the subscapularis tendon condition.

The follow-up time was 12 to 15 months with an average time of (13.2 ± 3.8) months. Before the operation and 1 year after operation, the mean UCLA score was (9.78 ± 1.88) points vs. (29.44 ± 2.56) points, and the mean constant score was (31.34± 3.89) points vs. (78.97 ± 5.84) points, respectively. The differences of the two indexes before and after operation were statistically significant (P<0.05) . The MacNab excellent and good rate was 90.47% at 1 year after operation. Patients with positive Bear Hug test and positive Belly press test showed a significant decrease after operation. All 21 patients had continuous subscapularis MRI images in the follow up. No complications such as vascular injury, nerve injury, anchor extraction or infection occurred.

The "Chinese knot" suture technique is simple and effective for subscapularis tendon repair, and its clinical effect is reliable.