Bhatia Sanjeev, Greenspoon Joshua A, Horan Marilee P, Warth Ryan J, Millett Peter J
Steadman Philippon Research Institute, Vail, Colorado, USA The Steadman Clinic, Vail, Colorado, USA.
Steadman Philippon Research Institute, Vail, Colorado, USA.
Am J Sports Med. 2015 Jul;43(7):1737-42. doi: 10.1177/0363546515577623. Epub 2015 Apr 1.
Outcomes after arthroscopic rotator cuff repair in recreational athletes older than 70 years are not widely reported.
To evaluate clinical outcomes after arthroscopic repair of full-thickness rotator cuff tears in recreational athletes aged 70 years or older.
Case series; Level of evidence, 4.
Institutional review board approval was obtained before initiation of this study. Data were collected prospectively and were retrospectively reviewed. From December 2005 to August 2012, patients who were at least 70 years of age, who described themselves as recreational athletes, and who underwent a primary or revision arthroscopic repair of full-thickness supraspinatus tears by a single surgeon were identified from a surgical registry. Demographic data, surgical data, and the following pre- and postoperative clinical outcomes scores were collected: American Shoulder and Elbow Surgeons (ASES), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form-12 Physical Component Summary (SF-12 PCS), and Single Assessment Numeric Evaluation (SANE). Acromiohumeral distance and Goutallier classifications were recorded. Patient satisfaction (range, 1-10, 10 = best) and reasons for activity modification were collected at final follow-up.
Forty-nine shoulders (44 patients) were included. The mean age was 73 years (range, 70-82 years). There were 33 men and 11 women (5 bilateral). The mean preoperative acromiohumeral distance was 9.2 mm (range, 3.0-15.9 mm). All patients had Goutallier classifications of 0, 1, or 2. Mean follow-up was 3.6 years (range, 2.0-6.9 years) in 43 of 49 (88%) shoulders. No rotator cuff repairs were revised, however, 1 patient had surgical treatment for stiffness. All postoperative outcomes measures demonstrated significant improvements when compared with their preoperative baselines. The mean ASES score was 90.3 (range, 60-100), the mean SANE score was 85.1 (range, 29-100), the mean QuickDASH score was 11.3 (0-50), and the mean SF-12 PCS score was 51.6 (range, 38-58) with a median patient satisfaction of 10 (range, 1-10). Patients who modified their recreational activities due to postoperative weakness were significantly less satisfied (P = .018). In this study, 24 of 31 (77%) who responded were able to return to their sport at a similar level of intensity.
Arthroscopic rotator cuff repair was highly effective at reducing pain, improving function, and returning patients to sport in recreational athletes 70 years of age and older.
70岁以上业余运动员关节镜下肩袖修复术后的结果尚未得到广泛报道。
评估70岁及以上业余运动员全层肩袖撕裂关节镜修复术后的临床结果。
病例系列;证据等级,4级。
在本研究开始前获得机构审查委员会的批准。数据前瞻性收集并进行回顾性分析。从2005年12月至2012年8月,从手术登记册中识别出年龄至少70岁、自称业余运动员且由单一外科医生进行全层冈上肌撕裂初次或翻修关节镜修复的患者。收集人口统计学数据、手术数据以及以下术前和术后临床结果评分:美国肩肘外科医师学会(ASES)评分、上肢、肩部和手部快速残疾评定量表(QuickDASH)、简短健康调查问卷12项身体成分汇总量表(SF-12 PCS)和单项评估数字评定量表(SANE)。记录肩峰下间隙和Goutallier分级。在末次随访时收集患者满意度(范围1-10分,10分为最佳)以及活动调整原因。
纳入49例肩部(44例患者)。平均年龄为73岁(范围70-82岁)。男性33例,女性11例(5例双侧)。术前平均肩峰下间隙为9.2 mm(范围3.0-15.9 mm)。所有患者的Goutallier分级为0、1或2级。49例肩部中的43例(88%)平均随访3.6年(范围2.0-6.9年)。没有肩袖修复进行翻修,然而,1例患者因僵硬接受了手术治疗。与术前基线相比,所有术后结果指标均有显著改善。ASES平均评分为90.3(范围60-100),SANE平均评分为85.1(范围29-100),QuickDASH平均评分为11.3(0-50),SF-12 PCS平均评分为51.6(范围38-58),患者中位满意度为10分(范围1-10)。因术后无力而调整业余活动项目的患者满意度明显较低(P = 0.018)。在本研究中,31例有回应的患者中有24例(77%)能够以相似的强度恢复运动。
关节镜下肩袖修复在减轻70岁及以上业余运动员的疼痛、改善功能以及使患者恢复运动方面非常有效。