探讨关节镜下肩袖修补联合喙突成形治疗肩袖撕裂合并喙突下囊肿的临床特征及意义。

收集2019年8月至2021年6月在南华大学附属第一医院骨科中心运动医学专科接受治疗肩袖撕裂合并喙突下囊肿的患者16例，所有患者均行关节镜下肩袖修补联合喙突成形术。于术前MRI测量喙肱间距，收集术前、术后3个月、术后6个月、术后12个月视觉模拟评分（visual analogue scale, VAS），肩关节被动外展、上举、外旋、摸背；术前及术后12个月肩关节美国加州大学肩关节评分（the University of California at Los Angeles shoulder rating scale, UCLA）、上肢功能评定表（disabilities of the arm,shoulder and hand, DASH）。

术前喙肱间距为（6.5±1.0）mm。术后喙肱间距为（8.8±0.6）mm，喙突下囊肿消失。VAS评分及被动外展、上举、外旋、摸背组内比较差异均有统计学意义（P<0.01）。各时间点之间比较，术后3个月，VAS评分及被动前屈活动度较术前均明显改善（P<0.05）；术后6个月，VAS评分及被动活动度较术前有明显改善（P<0.05）；术后6个月，VAS评分、被动外展及外旋活动度较术后3个月均有明显改善（P<0.05）；术后12个月，VAS评分与被动活动度较术后6个月差异无统计学意义（P>0.05）。术后12个月，VAS评分及被动活动度较术前及术后3个月均有明显改善（P<0.05）。术后12个月UCLA评分、DASH评分较术前有明显改善（P<0.01）。

喙突下囊肿可作为喙突成形术的参考指征，关节镜下肩袖修补联合喙突成形治疗合并喙突下囊肿的肩袖撕裂临床疗效好。

In recent years, with the rapid development of sports medicine and arthroscopic technology, the understanding of shoulder pain has become more in-depth, and shoulder arthroscopic surgery has achieved satisfactory clinical efficacy. Common causes of shoulder pain include rotator cuff tear, acromial impingement sign, frozen shoulder, etc. Currently, there are several clinical reports. Subcoracoplasty is also one of the causes of shoulder pain, with few reports so far, and the surgical indications and methods of coracoplasty are still controversial.

To investigate the clinical character and significance of subcoracoid cyst. Methods Sixteen patients with rotator cuff tears complicated with subcoracoid cysts were treated with arthroscopic rotator cuff repair combined with coracoplasty and admitted to the specialty of sports medicine in the department of Orthopedics of the First Affiliated Hospital of the University of South China from August 2019 to June 2021 were included in the study. The coracohumeral distances were measured on MRI. Clinical data of the patients was collected before surgery and three months, six months, and 12 months after surgery. The VAS score, passive range of motion (ROM) of the shoulder, UCLA shoulder score, and DASH upper limb function score were collected.

The coracohumeral distance was (6.5±1.0) mm. The postoperative coracohumeral distance was (8.8±0.6) mm, and the subcoracoid cyst disappeared. Significant differences existed in the above indexes within the group (P<0.01) . At postoperative three months, VAS scores and passive ROM of forward flexion were significantly improved compared with those before surgery (P<0.05) . At postoperative six months, VAS scores and passive ROM were better than those before the operation (P<0.05) , and VAS scores and passive ROM of abduction and external rotation were better than those before postoperative three months (P<0.05) . The VAS score and the passive ROM at postoperative 12 months were similar at six months (P>0.05) but better than that before the operation and postoperative three months (P<0.05) . The UCLA and DASH scores were better than those before the operation (P<0.01) .

Subcoracoid cyst would be a referential indication for coracoplasty. Arthroscopic rotator cuff repair combined with coracoplasty in treating rotator cuff tear complicated with medial subcoracoid cyst has good clinical results.