Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
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Follow-up Result in Repairing a Type II Superior Labrum Anterior and Posterior (SLAP) Lesion when Associated with Shoulder Impingement Syndrome

견관절 충돌 증후군과 동반된 제2형 SLAP 병변 봉합의 추시 결과

  • Lee, Sang-Myung (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Park, Jae-Chul (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Song, Seok-Whan (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Sang-Il (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Park, Bo-Youn (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine) ;
  • Rhee, Seung-Koo (Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine)
  • 이상명 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원) ;
  • 박재철 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원) ;
  • 송석환 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원) ;
  • 김상일 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원) ;
  • 박보연 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원) ;
  • 이승구 (가톨릭대학교 의과대학 정형외과학교실 여의도 성모병원)
  • Received : 2009.12.30
  • Accepted : 2010.05.06
  • Published : 2010.08.30
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Abstract

Purpose: Type II superior labral anterior posterior (SLAP) lesions can occur in the setting of impingement syndrome. The authors compared the clinical results of patients who had undergone either an isolated acromioplasty or a combined type II SLAP repair and acromioplasty. Materials and Methods: Between 2003 and 2008, a total of 75 cases of SLAP II lesions associated with impingement syndrome were recruited. In 39 patients, the type II SLAP lesion was repaired and acromioplasty was performed. In the other 35 patients, acromioplasty was performed alone. All patients were evaluated using the American Shoulder and Elbow Surgeons (ASES) questionnaire and range of motion. Results: At an average of 33 months postoperatively, the ASES scores significantly increased in both groups (p<0.001) but the ASES score was similar in the 2 groups (p=0.278). However, there was a significant difference in the ASES scores when the competitive sports activity of the 2 groups of patients postoperatively were compared (p=0.014). The SLAP repair patients showed limited external rotation motion compared to the acromioplasty alone patients (p=0.026). Conclusion: There are no advantages in repairing a type II SLAP lesion when associated with impingement syndrome. However, type II SLAP lesions should be repaired in patients involved with competitive sports activity but the competitive sports activity should be limited for a better result.

목적: 충돌 증후군과 동반된 제2형 SLAP 병변 환자를 대상으로 SLAP 병변 봉합 및 견봉성형술을 시행한(S+A) 군과 견봉성형술만 시행한(A) 군을 비교하여 SLAP 병변 봉합술이 필수적인 치료인지에 대하여 검정하려 한다. 대상 및 방법: 2003년부터 2008년까지 제2형 SLAP병변이 확진된 40세 이상의 충돌 증후군 환자 중 술 후 12개월 이상 관찰이 가능하였던 75예를 대상으로 하였다. 전 환자에서 견봉 성형술을 시행하였으며 이 중 39예는 SLAP 병변을 봉합하였고 36예는 봉합하지 않았다. 결과는 American Shoulder and Elbow Surgeons (ASES) 설문지 및 운동범위로 평가하였다. 결과: 술 후 평균 33개월이 경과한 후 ASES 점수는 두 군 모두 술 전에 비하여 술 후에 유의하게 증가하였으나(p<0.001) 두 군 간 유의한 차이는 없었다(p=0.278). 그러나 과격한 운동을 시행하는 군에서는 (S+A)군이 (A)군에 비하여 높은 ASES 점수를 보였다(p=0.014). 운동 범위는 (S+A)군이 (A)군에 비해 술 후 외회전이 유의하게 제한되었다(p=0.026). 결론: 40세 이상의 충돌 증후군을 동반한 제2형 SLAP 병변 환자에게 SLAP 병변 봉합술을 시행하는 경우 임상적 결과는 시행하지 않는 경우와 유의한 차이를 보이지 않았다. 또한 과격한 운동을 시행하는 환자는 SLAP 병변을 봉합하는 것이 임상적 결과가 좋으나 증상 호전을 위해서는 과격한 운동을 자제하여야 한다.

Keywords

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