Kukkonen Juha, Joukainen Antti, Lehtinen Janne, Aärimaa Ville
Department of Orthopaedics and Traumatology, Turku University Hospital, P.O. Box 28, 20701, Turku, Finland.
J Orthop Sci. 2013 May;18(3):405-9. doi: 10.1007/s00776-013-0369-2. Epub 2013 Mar 20.
Rotator cuff tear is considered to be a common source of shoulder pain and dysfunction. Osteoarthritis of the glenohumeral joint (OAG) may coexist with rotator cuff tear, especially in elderly patients. The aim of the study was to evaluate the effect of associated OAG on the treatment outcome of rotator cuff repair.
A total of 85 consecutive shoulders with an arthroscopically repaired isolated full-thickness supraspinatus tendon tear in males were included in this study. The grade of OAG was estimated preoperatively from shoulder radiographs using the Kellgren-Lawrence (K-L) classification, and peroperatively using the Outerbridge classification. Supraspinatus tendon tear was re-inserted anatomically to the native footprint in all cases. The Constant score was used as an outcome measure and was measured preoperatively and 1 year after the operation. The effect of OAG on the Constant score was analyzed statistically.
82 shoulders (96.5 %) were available for the 1-year follow-up. Preoperative OAG was detected in 22/82 patients (26.8 %). Any OAG above K-L grade 0 was associated with a lower Constant score preoperatively [49.9 (SD 17.6) vs. 60.1 (SD 16.7) (p = 0.0185)] and also at the 1-year follow-up [73.9 (SD 17.5) vs. 82.8 (SD 10.9) (p = 0.0074)]. 16/60 patients (26.7 %) with K-L grade 0 radiographs had peroperatively detected OAG. Furthermore, any peroperatively detected OAG was associated with a lower Constant score preoperatively [53.2 (SD 19.0) vs. 60.9 (SD 15.2) (p = 0.0445)] and at the 1-year follow-up 76.8 [(SD 14.8) vs. 83.5 (SD 11.4) (p = 0.0223)].
OAG is a relatively common finding in operated supraspinatus tear patients. Pre- and peroperatively detected OAG during rotator cuff reconstruction is predictive for lower pre- and postoperative Constant scores.
肩袖撕裂被认为是肩部疼痛和功能障碍的常见原因。盂肱关节骨关节炎（OAG）可能与肩袖撕裂并存，尤其是在老年患者中。本研究的目的是评估合并OAG对肩袖修复治疗效果的影响。
本研究纳入了85例连续的男性患者，这些患者均接受了关节镜下修复孤立性全层冈上肌腱撕裂手术。术前通过使用Kellgren-Lawrence（K-L）分类法从肩部X线片评估OAG的分级，术中使用Outerbridge分类法评估。所有病例中，冈上肌腱撕裂均在解剖学上重新附着于原附着点。采用Constant评分作为疗效指标，在术前和术后1年进行测量。对OAG对Constant评分的影响进行统计学分析。
82例肩部（96.5%）完成了1年的随访。22/82例患者（26.8%）术前检测到OAG。术前K-L分级高于0级的任何OAG均与较低的Constant评分相关[49.9（标准差17.6）对60.1（标准差16.7）（p = 0.0185）]，在1年随访时也是如此[73.9（标准差17.5）对82.8（标准差10.9）（p = 0.0074）]。16/60例（26.7%）术前K-L分级为0级的患者术中检测到OAG。此外，术中检测到的任何OAG术前均与较低的Constant评分相关[53.2（标准差19.0）对60.9（标准差15.2）（p = 0.0445）]，在1年随访时为76.8[（标准差14.8）对83.5（标准差11.4）（p = 0.0223）]。
OAG在接受手术的冈上肌撕裂患者中是一个相对常见的发现。在肩袖重建术前和术中检测到的OAG可预测术前和术后较低的Constant评分。
