Griffiths Stephanie, Yohannes A M
Ealing Community Services, Clayponds Hospital, London, UK.
Musculoskeletal Care. 2014 Jun;12(2):82-91. doi: 10.1002/msc.1058. Epub 2013 Aug 16.
Selecting the most appropriate patients to refer for surgery is crucial for high-quality and efficient clinical care. However, there are no specific referral criteria to guide the referral of appropriate patients for rotator cuff repair surgery. The aim of the present study was to design robust surgical referral criteria for patients with degenerative rotator cuff tears using consensus methodology. A two-round Delphi questionnaire was undertaken with a nationally representative sample of 41 specialist shoulder surgeons experienced in rotator cuff repair. Surgical referral criteria for degenerative rotator cuff tear were developed where consensus of at least 70% agreement was achieved. The initial questionnaire consisted of 24 items. Consensus was reached on 14 items, including: severity of pain, functional limitation, the identification of fat atrophy, agreement that a course of physiotherapy should be attempted before surgical referral, and exclusion for those with an active frozen shoulder. However, there was no consensus with regard to the dimensions of the tear. The surgical referral criteria developed were novel and promising for patients with degenerative rotator cuff tears, and further research is required to examine their efficacy.
选择最合适的患者进行手术转诊对于高质量和高效的临床护理至关重要。然而，目前尚无具体的转诊标准来指导将合适的患者转诊进行肩袖修复手术。本研究的目的是使用共识方法为退行性肩袖撕裂患者设计可靠的手术转诊标准。对41名在肩袖修复方面经验丰富的全国代表性专科肩部外科医生样本进行了两轮德尔菲问卷调查。制定了退行性肩袖撕裂的手术转诊标准，其中至少达成了70%的共识。初始问卷包括24个项目。就14个项目达成了共识，包括：疼痛严重程度、功能受限、脂肪萎缩的识别、在手术转诊前应尝试进行一个疗程物理治疗的共识，以及排除患有活动性肩周炎的患者。然而，对于撕裂的尺寸没有达成共识。所制定的手术转诊标准对于退行性肩袖撕裂患者来说是新颖且有前景的，需要进一步研究来检验其疗效。
