Department of Orthopaedic Surgery, College of Medicine, Inje University Busan Paik Hospital, Busan, South Korea.
J Shoulder Elbow Surg. 2012 Mar;21(3):304-9. doi: 10.1016/j.jse.2011.04.011. Epub 2011 Jul 20.
Stiffness after a rotator cuff tear is common, and it affects postoperative prognosis. This study aims to define the factors affecting stiffness that accompanies rotator cuff tear.
From June 2002 to May 2009 (84 months), 143 patients underwent arthroscopic rotator cuff repair. Of these, 119 were enrolled as subjects in this study. Preoperative range of motion was measured in all patients. Stiffness of the shoulder was defined as restriction of active and passive motion of 100° of elevation or less, less than 50% of external rotation, and internal rotation only to the sacrum. Factors that can affect stiffness were evaluated, including the type, size, and direction of rotator cuff; duration of symptoms; gender; age; presence of accompanying medical disease; degenerative factors (Goutallier classification); and presence of trauma. Retrospective analysis was conducted accordingly.
A statistically significantly higher degree of stiffness was seen for full-thickness tears than for partial-thickness tears (P = .0187). Between 2 groups that were divided by direction of rotator cuff tear, posterosuperior cuff tears showed a statistically significantly higher prevalence of stiffness (P = .0415). Patients with trauma had a statistically higher prevalence of stiffness (P = .0264). The other factors did not show significant differences.
In patients with rotator cuff tear, the type and direction of rotator cuff tear and the presence of trauma seem to increase the limitation of preoperative joint range of motion.
肩袖撕裂后出现僵硬很常见,并且会影响术后预后。本研究旨在明确影响肩袖撕裂伴发僵硬的因素。
2002 年 6 月至 2009 年 5 月(84 个月)期间,有 143 例行关节镜肩袖修复术患者,其中 119 例患者被纳入本研究。所有患者术前均测量关节活动度。肩关节僵硬定义为主动和被动活动度受限,外展 100°以下,外旋<50%,内旋仅至骶骨。评估可能影响僵硬的因素,包括肩袖的类型、大小和方向;症状持续时间;性别;年龄;是否存在伴随的内科疾病;退行性因素(Goutallier 分级);是否存在创伤。进行回顾性分析。
全层撕裂的僵硬程度显著高于部分撕裂(P=0.0187)。根据肩袖撕裂方向将 2 组分组,后上方肩袖撕裂僵硬的发生率显著更高(P=0.0415)。有创伤的患者僵硬的发生率显著更高(P=0.0264)。其他因素无显著差异。
在肩袖撕裂患者中,肩袖撕裂的类型和方向以及创伤似乎会增加术前关节活动度的限制。