Ryu Keun Jung, Kim Bang Hyun, Lee Yohan, Dan Jinmyoung, Kim Jae Hwa
Department of Orthopaedic Surgery, Severance Hospital, Yonsei Medical Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam-si, Kyeonggi-do, Republic of Korea.
Am J Sports Med. 2015 Jul;43(7):1743-50. doi: 10.1177/0363546515578101. Epub 2015 Apr 13.
Despite the essential role of vitamin D in muscle function, the prevalence of vitamin D deficiency has been reported to be very high. Recently, low vitamin D level was found to correlate with fatty degeneration of the rotator cuff tendon in humans and to negatively affect early healing at the rotator cuff repair site in an animal study. However, the effects of vitamin D level on severity of rotator cuff tear and healing after surgical repair have not been documented.
To evaluate (1) the prevalence of vitamin D deficiency among patients who underwent arthroscopic repair for a full-thickness rotator cuff tear, (2) the relationship of vitamin D level with severity of the rotator cuff tear, and (3) surgical outcomes after repair.
Cohort study; Level of evidence, 2.
A consecutive series of 91 patients (age, 50-65 years) who underwent arthroscopic rotator cuff repair for full-thickness, small-sized to massive tears were evaluated. Preoperative serum vitamin D levels (25-hydroxyvitamin) were analyzed to detect correlations with the features of a preoperative rotator cuff tear as well as postoperative structural and functional outcomes. All patients were followed clinically for a minimum of 1 year.
Preoperative vitamin D levels were deficient (<20 ng/mL) in 80 subjects (88%), insufficient (20-30 ng/mL) in 8 subjects (9%), and normal (>30 ng/mL) in 3 subjects (3%). No correlation was found between preoperative tear size (P = .23), extent of retraction (P = .60), degree of fatty infiltration of each cuff muscle (P > .50 each), or the global fatty infiltration index (P = .32). Similarly, no correlations were detected between vitamin D level and postoperative Sugaya type (P = .66) or any of the functional outcome scores (P > .50 each).
Low serum vitamin D level was not related to tear size, extent of retraction, or the degree of fatty infiltration in cuff muscles. It also had no significant relationships with postoperative structural integrity and functional outcomes after arthroscopic repair. The results suggest that low serum vitamin D level is not a significant risk factor for the severity of rotator cuff tear or poor healing after repair.
尽管维生素D在肌肉功能中起着至关重要的作用,但据报道维生素D缺乏的患病率非常高。最近,在一项动物研究中发现,低维生素D水平与人类肩袖肌腱脂肪变性相关,并对肩袖修复部位的早期愈合产生负面影响。然而,维生素D水平对肩袖撕裂严重程度及手术修复后愈合情况的影响尚未见报道。
评估(1)接受关节镜下全层肩袖撕裂修复手术患者中维生素D缺乏的患病率;(2)维生素D水平与肩袖撕裂严重程度的关系;(3)修复后的手术效果。
队列研究;证据等级:2级。
对连续91例年龄在50 - 65岁、因全层、小至巨大肩袖撕裂接受关节镜下肩袖修复的患者进行评估。分析术前血清维生素D水平(25 - 羟维生素D),以检测其与术前肩袖撕裂特征以及术后结构和功能结果之间的相关性。所有患者均接受至少1年的临床随访。
80例患者(88%)术前维生素D水平缺乏(<20 ng/mL),8例患者(9%)不足(20 - 30 ng/mL),3例患者(3%)正常(>30 ng/mL)。术前撕裂大小(P = 0.23)、回缩程度(P = 0.60)、各袖带肌肉脂肪浸润程度(各P > 0.50)或整体脂肪浸润指数(P = 0.32)之间均未发现相关性。同样,维生素D水平与术后Sugaya分型(P = 0.66)或任何功能结果评分(各P > 0.50)之间也未检测到相关性。
血清维生素D水平低与撕裂大小、回缩程度或袖带肌肉脂肪浸润程度无关。它与关节镜修复术后的结构完整性和功能结果也无显著关系。结果表明,血清维生素D水平低不是肩袖撕裂严重程度或修复后愈合不良的重要危险因素。