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开放性肩袖修复的结果。危险因素分析。

Outcome of open rotator cuff repair. An analysis of risk factors.

作者信息

Prasad Narayana, Odumala Abraham, Elias Farah, Jenkins Tony

机构信息

Royal Glamorgan Hospital, Llantrisant, United Kingdom.

出版信息

Acta Orthop Belg. 2005 Dec;71(6):662-6.

Abstract

The aim of this study was to evaluate the long-term functional outcome of full thickness rotator cuff tears treated by open repair and acromioplasty and to determine various factors affecting the outcome. This is a prospective clinical study on 42 patients who underwent full thickness rotator-cuff repair by a single surgeon between 2000 and 2003. The mean follow-up was 26 months. In patients with massive rotator cuff tear (n = 15), increase in the mean postoperative Constant score was significantly less compared to patients with small and moderate tears (p < 0.01). In patients older than sixty years, the improvement in postoperative Constant score was significantly less compared to the rest of the patients (p < 0.001). However, the postoperative Constant score significantly improved from the preoperative score in all patient groups (p < 0.0001). There was a significant negative correlation with size of cuff tear, age of the patient and Constant-Murley score (p < 0.05). Body mass index, smoking, gender, and the duration of symptoms did not have a significant effect on either Constant-Murley score or visual analogue score. We conclude that older patients and those with massive rotator cuff tear could benefit from surgical intervention, although not as much as younger patients and those with small/moderate size cuff tears.

摘要

本研究的目的是评估开放性修复和肩峰成形术治疗全层肩袖撕裂的长期功能结果,并确定影响结果的各种因素。这是一项对42例患者的前瞻性临床研究,这些患者在2000年至2003年间由同一位外科医生进行了全层肩袖修复。平均随访时间为26个月。在巨大肩袖撕裂患者(n = 15)中,术后Constant评分的平均增加明显低于小、中度撕裂患者(p < 0.01)。在60岁以上的患者中,术后Constant评分的改善明显低于其他患者(p < 0.001)。然而,所有患者组的术后Constant评分均较术前评分有显著改善(p < 0.0001)。肩袖撕裂大小、患者年龄与Constant-Murley评分之间存在显著负相关(p < 0.05)。体重指数、吸烟、性别和症状持续时间对Constant-Murley评分或视觉模拟评分均无显著影响。我们得出结论,老年患者和巨大肩袖撕裂患者可从手术干预中获益,尽管获益程度不如年轻患者和小/中度肩袖撕裂患者。

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