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肥胖是否会影响肩袖修复的早期结果?

Does obesity affect early outcome of rotator cuff repair?

机构信息

Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

J Shoulder Elbow Surg. 2010 Dec;19(8):1250-5. doi: 10.1016/j.jse.2010.03.003. Epub 2010 Jul 6.

Abstract

BACKGROUND

Obesity is linked to major health conditions and poor surgical outcomes. The impact of obesity on self-perceived outcome after rotator cuff repair (RCR) is unclear.

MATERIALS AND METHODS

We studied 154 patients who underwent RCR. Obesity was considered a body mass index (BMI) greater than 30. Preoperative and postoperative evaluations included the Disabilities of the Arm, Shoulder and Hand (DASH), Simple Shoulder Test, and visual analog scales for pain, function, and quality of life. Obese and control patients were compared for baseline demographics, surgical findings, and postoperative outcomes.

RESULTS

Our overall population had a mean BMI of 28.4 (95% confidence interval, 27.7-29.1). There were 57 obese patients (BMI >30) and 97 nonobese patients with 1- or 2-tendon rotator cuff tears. Mean follow-up was 54.8 weeks (range, 52.0-88.7 weeks). Preoperative DASH score was 45.2 for obese patients and 43.4 for control patients (P = .524). The mean improvement in DASH score was 30.7 for obese patients and 26.1 for nonobese patients (P = .152). There were no significant differences in the Simple Shoulder Test and visual analog scale scores. Worse follow-up DASH scores in both groups were associated with worker's compensation status (P = .003) and total comorbidities (P < .001). Multiple linear regression analysis showed that BMI (continuous) and obesity (dichotomous) were not significantly related to outcome after we controlled for confounding variables.

CONCLUSIONS

Although obesity is considered a risk factor for poor postoperative outcomes after some surgical procedures, in our experience, obesity does not have an independent, significant effect on self-reported early outcomes after RCR.

摘要

背景

肥胖与主要健康状况和较差的手术结果有关。肥胖对肩袖修复(RCR)后自我感知结果的影响尚不清楚。

材料和方法

我们研究了 154 名接受 RCR 的患者。肥胖被认为是体重指数(BMI)大于 30。术前和术后评估包括手臂、肩部和手的残疾(DASH)、简单肩部测试以及疼痛、功能和生活质量的视觉模拟量表。比较肥胖和对照组患者的基线人口统计学、手术发现和术后结果。

结果

我们的总体人群平均 BMI 为 28.4(95%置信区间,27.7-29.1)。有 57 名肥胖患者(BMI>30)和 97 名非肥胖患者,有 1 或 2 根肌腱肩袖撕裂。平均随访时间为 54.8 周(范围,52.0-88.7 周)。肥胖患者的术前 DASH 评分为 45.2,对照组患者为 43.4(P =.524)。肥胖患者的 DASH 评分平均改善 30.7,非肥胖患者为 26.1(P =.152)。简单肩部测试和视觉模拟量表评分无显着差异。两组随访 DASH 评分较差均与工人赔偿状况(P =.003)和总合并症(P <.001)相关。多元线性回归分析表明,在控制混杂因素后,BMI(连续)和肥胖(二分类)与 RCR 后结局无显着相关性。

结论

尽管肥胖被认为是某些手术后术后不良结果的危险因素,但根据我们的经验,肥胖对 RCR 后自我报告的早期结果没有独立的显着影响。

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