美國(guó)骨科醫(yī)師學(xué)會(huì)肩袖損傷臨床實(shí)踐指南解讀

美國(guó)骨科醫(yī)師學(xué)會(huì)肩袖損傷臨床實(shí)踐指南解讀一、本文概述Overviewofthisarticle本文旨在對(duì)《美國(guó)骨科醫(yī)師學(xué)會(huì)肩袖損傷臨床實(shí)踐指南》進(jìn)行深度解讀。該指南作為美國(guó)骨科醫(yī)師學(xué)會(huì)（AAOS）發(fā)布的權(quán)威性文件，為肩袖損傷的診斷、治療和康復(fù)提供了全面、系統(tǒng)的指導(dǎo)。本文將從指南的核心內(nèi)容出發(fā)，結(jié)合國(guó)內(nèi)外相關(guān)研究和臨床實(shí)踐，對(duì)肩袖損傷的定義、分類、診斷方法、治療策略以及康復(fù)措施進(jìn)行詳盡闡述，旨在幫助讀者更好地理解和應(yīng)用該指南，提高肩袖損傷的治療效果，促進(jìn)患者康復(fù)。本文還將探討指南中的亮點(diǎn)與爭(zhēng)議點(diǎn)，以期引發(fā)行業(yè)內(nèi)更廣泛的討論與交流，共同推動(dòng)肩袖損傷臨床實(shí)踐的進(jìn)步與發(fā)展。Thisarticleaimstoprovideanin-depthinterpretationoftheClinicalPracticeGuidelinesforrotatorcuffinjuriesbytheAmericanAcademyofOrthopedicPhysicians.Thisguideline,asanauthoritativedocumentpublishedbytheAmericanAcademyofOrthopaedicSurgeons(AAOS),providescomprehensiveandsystematicguidanceforthediagnosis,treatment,andrehabilitationofrotatorcuffinjuries.Thisarticlewillstartfromthecorecontentoftheguidelines,combinedwithrelevantresearchandclinicalpracticeathomeandabroad,toprovideadetailedexplanationofthedefinition,classification,diagnosticmethods,treatmentstrategies,andrehabilitationmeasuresofrotatorcuffinjury.Theaimistohelpreadersbetterunderstandandapplytheguidelines,improvethetreatmenteffectofrotatorcuffinjury,andpromotepatientrecovery.Thisarticlewillalsoexplorethehighlightsandcontroversiesintheguidelines,inordertotriggerbroaderdiscussionsandexchangeswithintheindustry,andjointlypromotetheprogressanddevelopmentofclinicalpracticeforrotatorcuffinjury.二、AAOS肩袖損傷臨床實(shí)踐指南概述OverviewofclinicalpracticeguidelinesforAAOSrotatorcuffinjury美國(guó)骨科醫(yī)師學(xué)會(huì)（AAOS）發(fā)布的肩袖損傷臨床實(shí)踐指南，旨在為骨科醫(yī)生提供一個(gè)權(quán)威、科學(xué)、實(shí)用的參考，以指導(dǎo)他們?cè)谠\斷和治療肩袖損傷過(guò)程中的臨床實(shí)踐。這份指南充分結(jié)合了最新的科學(xué)研究成果和臨床實(shí)踐經(jīng)驗(yàn)，旨在為醫(yī)生提供一個(gè)全面、系統(tǒng)的治療策略。TheClinicalPracticeGuidelinesforrotatorcuffinjuriespublishedbytheAmericanAcademyofOrthopaedicSurgeons(AAOS)aimtoprovideorthopedicdoctorswithanauthoritative,scientific,andpracticalreferencetoguidetheirclinicalpracticeinthediagnosisandtreatmentofrotatorcuffinjuries.Thisguidefullycombinesthelatestscientificresearchachievementsandclinicalpracticeexperience,aimingtoprovidedoctorswithacomprehensiveandsystematictreatmentstrategy.肩袖損傷的診斷：指南詳細(xì)介紹了肩袖損傷的診斷流程，包括病史采集、體格檢查和影像學(xué)檢查等方面，幫助醫(yī)生準(zhǔn)確判斷肩袖損傷的類型和程度。Diagnosisofrotatorcuffinjury:Theguideprovidesadetailedintroductiontothediagnosticprocessofrotatorcuffinjury,includingmedicalhistorycollection,physicalexamination,andimagingexamination,tohelpdoctorsaccuratelydeterminethetypeanddegreeofrotatorcuffinjury.肩袖損傷的治療：指南針對(duì)不同類型和程度的肩袖損傷，提供了詳細(xì)的治療建議，包括保守治療和手術(shù)治療兩種方式。保守治療主要包括藥物治療、物理治療和康復(fù)訓(xùn)練等，而手術(shù)治療則包括開(kāi)放手術(shù)和關(guān)節(jié)鏡手術(shù)等。Thetreatmentofrotatorcuffinjury:Thecompassprovidesdetailedtreatmentrecommendationsfordifferenttypesanddegreesofrotatorcuffinjuries,includingconservativetreatmentandsurgicaltreatment.Conservativetreatmentmainlyincludesdrugtherapy,physicaltherapy,andrehabilitationtraining,whilesurgicaltreatmentincludesopensurgeryandarthroscopicsurgery.康復(fù)與預(yù)后：指南強(qiáng)調(diào)了康復(fù)訓(xùn)練在肩袖損傷治療中的重要性，提供了具體的康復(fù)計(jì)劃和預(yù)后評(píng)估標(biāo)準(zhǔn)，幫助醫(yī)生更好地指導(dǎo)患者進(jìn)行康復(fù)訓(xùn)練，促進(jìn)肩袖損傷的恢復(fù)。Rehabilitationandprognosis:Theguidelinesemphasizetheimportanceofrehabilitationtraininginthetreatmentofrotatorcuffinjuries,providingspecificrehabilitationplansandprognosticevaluationcriteriatohelpdoctorsbetterguidepatientsinrehabilitationtrainingandpromotetherecoveryofrotatorcuffinjuries.并發(fā)癥的預(yù)防與處理：指南還介紹了肩袖損傷治療過(guò)程中可能出現(xiàn)的并發(fā)癥及其預(yù)防措施，以及并發(fā)癥發(fā)生后的處理方法，幫助醫(yī)生有效避免和應(yīng)對(duì)可能出現(xiàn)的風(fēng)險(xiǎn)。PreventionandManagementofComplications:Theguidealsointroducesthepossiblecomplicationsandpreventivemeasuresthatmayoccurduringthetreatmentofrotatorcuffinjuries,aswellasthemanagementmethodsaftercomplicationsoccur,helpingdoctorseffectivelyavoidandrespondtopotentialrisks.AAOS肩袖損傷臨床實(shí)踐指南是一份全面、系統(tǒng)的治療策略，旨在為骨科醫(yī)生提供權(quán)威、科學(xué)、實(shí)用的參考，幫助他們更好地診斷和治療肩袖損傷患者，提高治療效果和患者滿意度。TheAAOSClinicalPracticeGuidelinesforrotatorcuffinjuriesareacomprehensiveandsystematictreatmentstrategyaimedatprovidingauthoritative,scientific,andpracticalreferencesfororthopedicdoctors,helpingthembetterdiagnoseandtreatpatientswithrotatorcuffinjuries,andimprovingtreatmenteffectivenessandpatientsatisfaction.三、肩袖損傷的診斷Diagnosisofrotatorcuffinjury肩袖損傷的正確診斷對(duì)于患者的有效治療至關(guān)重要。美國(guó)骨科醫(yī)師學(xué)會(huì)（AAOS）針對(duì)肩袖損傷的臨床實(shí)踐指南為醫(yī)生們提供了一套系統(tǒng)且實(shí)用的診斷流程。Thecorrectdiagnosisofrotatorcuffinjuryiscrucialforeffectivetreatmentofpatients.TheAmericanAcademyofOrthopaedicSurgeons(AAOS)clinicalpracticeguidelinesforrotatorcuffinjuriesprovidedoctorswithasystematicandpracticaldiagnosticprocess.診斷肩袖損傷應(yīng)基于患者的病史和體格檢查。醫(yī)生會(huì)詢問(wèn)患者疼痛的部位、性質(zhì)、時(shí)間和誘發(fā)因素，以及是否有過(guò)肩部的外傷或過(guò)度使用。在體格檢查中，醫(yī)生會(huì)對(duì)患者的肩部進(jìn)行一系列活動(dòng)，觀察患者是否出現(xiàn)疼痛或力量減弱等癥狀。Thediagnosisofrotatorcuffinjuryshouldbebasedonthepatient'smedicalhistoryandphysicalexamination.Doctorswillaskpatientsaboutthelocation,nature,duration,andtriggeringfactorsofpain,aswellaswhethertherehasbeenanyshoulderinjuryoroveruse.Duringphysicalexamination,doctorswillperformaseriesofactivitiesonthepatient'sshoulderstoobservewhethertheyexperiencesymptomssuchaspainorweakenedstrength.影像學(xué)檢查在肩袖損傷的診斷中扮演著重要角色。最常用的影像學(xué)檢查方法是線平片，它可以幫助醫(yī)生排除肩部骨折或脫位等可能性。然而，由于線平片對(duì)軟組織損傷的診斷能力有限，因此在懷疑肩袖損傷時(shí)，醫(yī)生通常會(huì)推薦進(jìn)行磁共振成像（MRI）檢查。MRI能夠清晰地顯示出肩袖組織的結(jié)構(gòu)和損傷程度，為醫(yī)生提供更為準(zhǔn)確的診斷依據(jù)。Imagingexaminationplaysanimportantroleinthediagnosisofrotatorcuffinjury.ThemostcommonlyusedimagingexaminationmethodisX-ray,whichcanhelpdoctorsruleoutthepossibilityofshoulderfracturesordislocations.However,duetothelimiteddiagnosticabilityofplainfilmsforsofttissueinjuries,doctorsusuallyrecommendmagneticresonanceimaging(MRI)whensuspectingrotatorcuffinjuries.MRIcanclearlydisplaythestructureanddegreeofinjuryoftherotatorcufftissue,providingdoctorswithmoreaccuratediagnosticevidence.關(guān)節(jié)鏡檢查也是一種常用的診斷方法，特別是對(duì)于難以通過(guò)影像學(xué)檢查明確診斷的病例。關(guān)節(jié)鏡是一種微創(chuàng)的手術(shù)技術(shù)，醫(yī)生通過(guò)一個(gè)小切口將關(guān)節(jié)鏡插入患者的肩關(guān)節(jié)內(nèi)部，直接觀察肩袖組織的損傷情況。這種方法不僅診斷準(zhǔn)確率高，還可以在必要時(shí)進(jìn)行同時(shí)的手術(shù)治療。Arthroscopyisalsoacommonlyuseddiagnosticmethod,especiallyforcasesthataredifficulttodiagnosethroughimagingexaminations.Arthroscopyisaminimallyinvasivesurgicaltechniqueinwhichdoctorsinsertthearthroscopeintothepatient'sshoulderjointthroughasmallincision,directlyobservingthedamagetotherotatorcufftissue.Thismethodnotonlyhashighdiagnosticaccuracy,butalsoallowsforsimultaneoussurgicaltreatmentwhennecessary.美國(guó)骨科醫(yī)師學(xué)會(huì)指南強(qiáng)調(diào)，診斷肩袖損傷時(shí)應(yīng)綜合考慮患者的病史、體格檢查和影像學(xué)檢查結(jié)果。醫(yī)生應(yīng)根據(jù)患者的具體情況選擇合適的診斷方法，確保診斷的準(zhǔn)確性和及時(shí)性。醫(yī)生還應(yīng)注意與其他可能引起肩部疼痛的疾病進(jìn)行鑒別，如肩周炎、肩袖鈣化等，以免誤診或漏診。TheguidelinesoftheAmericanAcademyofOrthopaedicPhysiciansemphasizethatwhendiagnosingrotatorcuffinjuries,acomprehensiveconsiderationshouldbegiventothepatient'smedicalhistory,physicalexamination,andimagingresults.Doctorsshouldchooseappropriatediagnosticmethodsbasedonthespecificsituationofpatientstoensuretheaccuracyandtimelinessofdiagnosis.Doctorsshouldalsopayattentiontodistinguishingfromotherdiseasesthatmaycauseshoulderpain,suchasshoulderperiarthritis,rotatorcuffcalcification,toavoidmisdiagnosisormisseddiagnosis.正確的診斷是肩袖損傷有效治療的前提。遵循美國(guó)骨科醫(yī)師學(xué)會(huì)的臨床實(shí)踐指南，結(jié)合患者的具體情況選擇合適的診斷方法，將有助于醫(yī)生準(zhǔn)確診斷肩袖損傷并制定相應(yīng)的治療方案。Acorrectdiagnosisisaprerequisiteforeffectivetreatmentofrotatorcuffinjury.FollowingtheclinicalpracticeguidelinesoftheAmericanAcademyofOrthopedicPhysiciansandselectingappropriatediagnosticmethodsbasedonthespecificsituationofpatientswillhelpdoctorsaccuratelydiagnoserotatorcuffinjuriesanddevelopcorrespondingtreatmentplans.四、肩袖損傷的治療Treatmentofrotatorcuffinjury肩袖損傷的治療方案通常取決于損傷的嚴(yán)重程度、患者的年齡和健康狀況，以及他們的活動(dòng)需求。美國(guó)骨科醫(yī)師學(xué)會(huì)（AAOS）在其肩袖損傷臨床實(shí)踐指南中，為醫(yī)生提供了一套全面的治療建議。Thetreatmentplanforrotatorcuffinjuryusuallydependsontheseverityoftheinjury,thepatient'sageandhealthstatus,andtheiractivityneeds.TheAmericanAcademyofOrthopaedicSurgeons(AAOS)providesdoctorswithacomprehensivesetoftreatmentrecommendationsinitsclinicalpracticeguidelinesforrotatorcuffinjuries.非手術(shù)治療：對(duì)于輕度至中度的肩袖損傷，非手術(shù)治療通常是首選。這可能包括休息、冰敷、物理治療和藥物治療（如非處方藥用于緩解疼痛和炎癥）。特定的肩袖鍛煉和康復(fù)程序可能有助于恢復(fù)肩袖的功能和力量。Nonsurgicaltreatment:Formildtomoderaterotatorcuffinjuries,non-surgicaltreatmentisusuallypreferred.Thismayincluderest,icecompress,physicaltherapy,andmedicationtherapy(suchasover-the-counterdrugsusedtorelievepainandinflammation).Specificrotatorcuffexercisesandrehabilitationprogramsmayhelprestorerotatorcufffunctionandstrength.手術(shù)治療：對(duì)于重度肩袖損傷，或者當(dāng)非手術(shù)治療無(wú)效時(shí)，可能需要進(jìn)行手術(shù)。手術(shù)的主要目標(biāo)是修復(fù)肩袖，恢復(fù)其正常的解剖結(jié)構(gòu)和功能。手術(shù)方法可能包括開(kāi)放手術(shù)或關(guān)節(jié)鏡手術(shù)，具體取決于損傷的類型和程度。Surgicaltreatment:Forsevererotatorcuffinjuries,orwhennon-surgicaltreatmentisineffective,surgerymaybenecessary.Themainobjectiveofsurgeryistorepairtherotatorcuff,restoreitsnormalanatomicalstructureandfunction.Surgicalmethodsmayincludeopensurgeryorarthroscopicsurgery,dependingonthetypeanddegreeofinjury.術(shù)后康復(fù)：無(wú)論是選擇非手術(shù)治療還是手術(shù)治療，康復(fù)都是關(guān)鍵的一部分。在術(shù)后康復(fù)期間，患者需要在醫(yī)生的指導(dǎo)下進(jìn)行特定的物理治療和鍛煉，以幫助恢復(fù)肩袖的功能和力量。Postoperativerehabilitation:Whetherchoosingnon-surgicalorsurgicaltreatment,rehabilitationisacrucialpart.Duringpostoperativerehabilitation,patientsneedtoundergospecificphysicaltherapyandexerciseundertheguidanceofadoctortohelprestorethefunctionandstrengthoftherotatorcuff.肩袖損傷的治療是一個(gè)個(gè)體化的過(guò)程，需要根據(jù)患者的具體情況進(jìn)行決策。美國(guó)骨科醫(yī)師學(xué)會(huì)的肩袖損傷臨床實(shí)踐指南為醫(yī)生提供了寶貴的指導(dǎo)，幫助他們?yōu)榛颊咧贫ㄗ罴训闹委煼桨?。通過(guò)綜合考慮患者的需求、損傷的程度和可用的治療方法，醫(yī)生可以為患者提供最有效和最適合的治療。Thetreatmentofrotatorcuffinjuryisanindividualizedprocessthatrequiresdecision-makingbasedonthepatient'sspecificsituation.TheclinicalpracticeguidelinesforrotatorcuffinjuriesfromtheAmericanAcademyofOrthopedicPhysiciansprovidevaluableguidancetodoctors,helpingthemdevelopthebesttreatmentplanforpatients.Bycomprehensivelyconsideringthepatient'sneeds,degreeofinjury,andavailabletreatmentmethods,doctorscanprovidethemosteffectiveandsuitabletreatmentforpatients.五、肩袖損傷的預(yù)后與康復(fù)Prognosisandrehabilitationofrotatorcuffinjury肩袖損傷的恢復(fù)過(guò)程往往需要一段時(shí)間，且預(yù)后受多種因素影響，包括損傷的嚴(yán)重程度、患者的年齡和健康狀況、治療方法的選擇等。一般來(lái)說(shuō)，輕微的肩袖損傷可能通過(guò)保守治療，如休息、冷敷、藥物治療和物理治療等，在數(shù)周至數(shù)月內(nèi)恢復(fù)。然而，對(duì)于嚴(yán)重的肩袖損傷，特別是那些涉及肩袖全層撕裂的情況，可能需要手術(shù)治療。Therecoveryprocessofrotatorcuffinjuryoftenrequiresaperiodoftime,andtheprognosisisinfluencedbyvariousfactors,includingtheseverityoftheinjury,thepatient'sageandhealthstatus,andthechoiceoftreatmentmethods.Generallyspeaking,minorrotatorcuffinjuriesmaybetreatedconservatively,suchasrest,coldcompress,medication,andphysicaltherapy,andcanrecoverwithinweekstomonths.However,forsevererotatorcuffinjuries,especiallythoseinvolvingfull-thicknessrotatorcufftears,surgicaltreatmentmaybenecessary.手術(shù)治療肩袖損傷的主要目的是修復(fù)撕裂的肩袖，恢復(fù)肩關(guān)節(jié)的穩(wěn)定性和功能。手術(shù)后的康復(fù)過(guò)程至關(guān)重要，它決定了患者能否完全恢復(fù)肩關(guān)節(jié)的功能?？祻?fù)計(jì)劃通常包括疼痛控制、炎癥管理、關(guān)節(jié)活動(dòng)度訓(xùn)練、肌肉力量訓(xùn)練和日常生活活動(dòng)訓(xùn)練等。Themainpurposeofsurgicaltreatmentforrotatorcuffinjuryistorepairthetornrotatorcuff,restorethestabilityandfunctionoftheshoulderjoint.Thepostoperativerehabilitationprocessiscrucialasitdetermineswhetherthepatientcanfullyrecoverthefunctionoftheshoulderjoint.Rehabilitationplanstypicallyincludepaincontrol,inflammationmanagement,jointrangeofmotiontraining,musclestrengthtraining,anddailylivingactivitytraining.在康復(fù)過(guò)程中，患者應(yīng)遵循醫(yī)生的建議，逐步進(jìn)行康復(fù)訓(xùn)練。早期階段，重點(diǎn)是控制疼痛和炎癥，避免過(guò)度活動(dòng)導(dǎo)致?lián)p傷加重。隨著疼痛和炎癥的減輕，可以逐漸增加關(guān)節(jié)活動(dòng)度和肌肉力量訓(xùn)練。這個(gè)階段需要耐心和毅力，因?yàn)榭祻?fù)訓(xùn)練可能會(huì)帶來(lái)一些不適和挑戰(zhàn)。Duringtherehabilitationprocess,patientsshouldfollowthedoctor'sadviceandgraduallyundergorehabilitationtraining.Intheearlystages,thefocusisoncontrollingpainandinflammation,avoidingexcessiveactivitythatcanworsenthedamage.Aspainandinflammationdecrease,jointrangeofmotionandmusclestrengthtrainingcangraduallyincrease.Thisstagerequirespatienceandperseverance,asrehabilitationtrainingmaybringsomediscomfortandchallenges.整體而言，肩袖損傷的預(yù)后因個(gè)體差異而異。年輕、健康且損傷程度較輕的患者通常預(yù)后較好，能夠較快地恢復(fù)肩關(guān)節(jié)的功能。然而，對(duì)于年齡較大、身體狀況較差或損傷程度較重的患者，恢復(fù)可能需要更長(zhǎng)時(shí)間，且可能無(wú)法完全恢復(fù)到損傷前的狀態(tài)。Overall,theprognosisofrotatorcuffinjuryvariesamongindividuals.Young,healthy,andmildlyinjuredpatientsusuallyhaveabetterprognosisandcanquicklyrecovershoulderjointfunction.However,forolderpatientswithpoorphysicalconditionorsevereinjury,recoverymaytakelongerandmaynotfullyrecovertothepreinjurystate.肩袖損傷的恢復(fù)是一個(gè)復(fù)雜而漫長(zhǎng)的過(guò)程，需要患者的耐心和合作。通過(guò)與醫(yī)生緊密合作，遵循康復(fù)計(jì)劃，并進(jìn)行適當(dāng)?shù)目祻?fù)訓(xùn)練，大多數(shù)患者都能夠逐漸改善肩關(guān)節(jié)的功能，并恢復(fù)到正常的生活和工作狀態(tài)。Therecoveryofrotatorcuffinjuryisacomplexandlengthyprocessthatrequirespatientpatienceandcooperation.Byworkingcloselywithdoctors,followingrehabilitationplans,andconductingappropriaterehabilitationtraining,mostpatientsareabletograduallyimproveshoulderjointfunctionandreturntonormallivingandworkingconditions.六、AAOS指南的爭(zhēng)議與討論ControversyandDiscussionofAAOSGuidelines盡管AAOS（美國(guó)骨科醫(yī)師學(xué)會(huì)）的肩袖損傷臨床實(shí)踐指南為醫(yī)生們提供了有價(jià)值的參考和指導(dǎo)，但圍繞其仍存在一些爭(zhēng)議和討論點(diǎn)。AlthoughtheAAOS(AmericanAcademyofOrthopaedicPhysicians)clinicalpracticeguidelinesforrotatorcuffinjuriesprovidevaluablereferenceandguidancefordoctors,therearestillsomecontroversiesanddiscussionpointssurroundingthem.AAOS指南的制定基于大量的臨床研究和專家共識(shí)，然而，不同地區(qū)、不同人群、不同醫(yī)療環(huán)境下的肩袖損傷情況可能存在差異。因此，指南的普遍適用性受到一定程度的質(zhì)疑。一些醫(yī)生認(rèn)為，在實(shí)際應(yīng)用中，需要根據(jù)具體情況對(duì)指南進(jìn)行適當(dāng)調(diào)整。ThedevelopmentofAAOSguidelinesisbasedonalargenumberofclinicalstudiesandexpertconsensus.However,theremaybedifferencesintheincidenceofrotatorcuffinjuriesamongdifferentregions,populations,andmedicalenvironments.Therefore,theuniversalapplicabilityoftheguidelineshasbeenquestionedtoacertainextent.Somedoctorsbelievethatinpracticalapplications,itisnecessarytomakeappropriateadjustmentstotheguidelinesbasedonspecificcircumstances.指南中對(duì)于非手術(shù)治療和手術(shù)治療的選擇給出了明確的建議，但在實(shí)際操作中，醫(yī)生們對(duì)于某些特定情況下的治療選擇仍存在分歧。例如，對(duì)于一些較小或中度的肩袖損傷，非手術(shù)治療往往能取得較好的效果，但對(duì)于一些大型或復(fù)雜的肩袖損傷，手術(shù)治療可能更為合適。因此，如何準(zhǔn)確判斷并選擇最佳治療方案仍是醫(yī)生們需要面對(duì)的挑戰(zhàn)。Theguidelinesprovideclearrecommendationsfortheselectionofnon-surgicalandsurgicaltreatments,butinpracticalpractice,doctorsstillhavedifferencesinthetreatmentchoicesforcertainspecificsituations.Forexample,forsomesmallormoderaterotatorcuffinjuries,non-surgicaltreatmentcanoftenachievebetterresults,butforsomelargeorcomplexrotatorcuffinjuries,surgicaltreatmentmaybemoreappropriate.Therefore,howtoaccuratelyjudgeandchoosethebesttreatmentplanisstillachallengethatdoctorsneedtoface.肩袖損傷的治療不僅僅是手術(shù)或非手術(shù)治療的選擇，術(shù)后的康復(fù)和功能恢復(fù)同樣重要。指南中對(duì)于術(shù)后康復(fù)給出了建議，但具體的康復(fù)方案和進(jìn)度可能因患者而異。一些醫(yī)生認(rèn)為，康復(fù)過(guò)程中的個(gè)體差異較大，需要根據(jù)患者的具體情況進(jìn)行個(gè)性化調(diào)整。Thetreatmentofrotatorcuffinjuryisnotonlyachoiceofsurgicalornon-surgicaltreatment,butalsoimportantforpostoperativerecoveryandfunctionalrecovery.Theguidelinesproviderecommendationsforpostoperativerehabilitation,butthespecificrehabilitationplanandprogressmayvarydependingonthepatient.Somedoctorsbelievethattherearesignificantindividualdifferencesintherehabilitationprocess,andpersonalizedadjustmentsneedtobemadebasedonthespecificsituationofthepatient.隨著醫(yī)學(xué)技術(shù)的不斷進(jìn)步，新的治療方法和技術(shù)不斷涌現(xiàn)。AAOS指南作為一個(gè)權(quán)威的指導(dǎo)文件，需要不斷更新和完善以適應(yīng)新技術(shù)的發(fā)展。然而，新技術(shù)的安全性和有效性需要經(jīng)過(guò)長(zhǎng)期的驗(yàn)證和實(shí)踐才能被廣泛接受和應(yīng)用。因此，如何在保證指南的穩(wěn)定性和權(quán)威性的及時(shí)納入新技術(shù)和研究成果，是AAOS指南未來(lái)發(fā)展中需要面對(duì)的問(wèn)題。Withthecontinuousprogressofmedicaltechnology,newtreatmentmethodsandtechnologiesareconstantlyemerging.TheAAOSguide,asanauthoritativeguidancedocument,needstobeconstantlyupdatedandimprovedtoadapttothedevelopmentofnewtechnologies.However,thesecurityandeffectivenessofnewtechnologiesrequirelong-termvalidationandpracticeinordertobewidelyacceptedandapplied.Therefore,howtotimelyincorporatenewtechnologiesandresearchresultswhileensuringthestabilityandauthorityoftheAAOSguidelinesisaproblemthatneedstobefacedinthefuturedevelopmentoftheguidelines.AAOS的肩袖損傷臨床實(shí)踐指南雖然為醫(yī)生們提供了寶貴的參考和指導(dǎo)，但仍存在一些爭(zhēng)議和討論點(diǎn)。隨著醫(yī)學(xué)技術(shù)的不斷發(fā)展和臨床實(shí)踐的深入進(jìn)行，相信這些爭(zhēng)議和討論將逐漸得到解決和完善。AlthoughtheclinicalpracticeguidelinesforrotatorcuffinjuriesinAAOSprovidevaluablereferenceandguidancefordoctors,therearestillsomecontroversiesanddiscussionpoints.Withthecontinuousdevelopmentofmedicaltechnologyandthedeepeningofclinicalpractice,itisbelievedthatthesecontroversiesanddiscussionswillgraduallyberesolvedandimproved.七、結(jié)論Conclusion本文深入解讀了《美國(guó)骨科醫(yī)師學(xué)會(huì)肩袖損傷臨床實(shí)踐指南》，以期對(duì)我國(guó)的肩袖損傷臨床治療和研究提供借鑒和指導(dǎo)。該指南的發(fā)布，標(biāo)志著肩袖損傷的治療已經(jīng)進(jìn)入了更為精細(xì)化、個(gè)體化的新時(shí)代，其提出的各種診斷、治療和康復(fù)方案，均為當(dāng)前全球骨科領(lǐng)域在該領(lǐng)域的最新成果和實(shí)踐經(jīng)驗(yàn)的結(jié)晶。Thisarticleprovidesanin-depthinterpretationoftheAmericanAcademyofOrthopaedicPhysiciansClinicalPracticeGuidelinesforrotatorcuffinjuries,inordertoprovidereferenceandguidancefortheclinicaltreatmentandresearchofrotatorcuffinjuriesinChina.Thereleaseofthisguidelinemarksaneweraofmorerefinedandpersonalizedtreatmentforrotatorcuffinjuries.Thevariousdiagnostic,treatment,andrehabilitationplansproposedbyitarethecrystallizationofthelatestachievementsand