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作者

李 宁 迟少毅 李 剑 刘宏宇 彭 林 刘建强

作者单位

山东第一医科大学(山东省医学科学院)，山东 济南 济南市第四人民医院关节与运动医学科，山东 济南

刊名

Advances in Clinical Medicine

年份

2026

卷号

Vol.16 No.6

页码

966-972

ISSN

2161-8712

关键词

强直性脊柱炎 肩袖损伤 关节镜 病例报告 Ankylosing Spondylitis Rotator Cuff Tear Arthroscopy Case Report

摘要

Objective: To investigate the clinical characteristics, pathogenesis, and perioperative management strategies for ankylosing spondylitis complicated by a massive rotator cuff tear. Methods: A 47-year-old male patient with AS was admitted with right shoulder pain and limited range of motion persisting for 3 weeks following trauma. Preoperative MRI confirmed a massive tear of the supraspinatus and infraspinatus tendons . Arthroscopic rotator cuff repair combined with transfer and fixation of the ...更多

Objective: To investigate the clinical characteristics, pathogenesis, and perioperative management strategies for ankylosing spondylitis complicated by a massive rotator cuff tear. Methods: A 47-year-old male patient with AS was admitted with right shoulder pain and limited range of motion persisting for 3 weeks following trauma. Preoperative MRI confirmed a massive tear of the supraspinatus and infraspinatus tendons . Arthroscopic rotator cuff repair combined with transfer and fixation of the long head of the biceps tendon was performed, and the relevant literature was reviewed. Results: Intraoperatively, marked synovial hyperplasia was observed, and the tendons were notably friable and retracted, confirming the tendon degeneration underlying chronic enthesitis in AS. Postoperatively, the patient’s pain was significantly relieved, the wound healed well, and the short-term outcome was satisfactory. During the perioperative period, following consultation with the rheumatology department, etoricoxib was initiated, and subsequent biologic therapy was planned, thereby achieving multidisciplinary team management. Conclusion: AS is an important risk factor for rotator cuff tears. The underlying mechanisms involve enthesitis-induced deterioration of tendon quality, abnormal shoulder biomechanics resulting from kyphotic deformity, and secondary subacromial impingement. For such patients, combining arthroscopic repair of the local injury with MDT-based systemic inflammation may be a promising therapeutic strategy.收起

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