Inderhaug Eivind, Kollevold Kristin H, Kalsvik Maiken, Hegna Janne, Solheim Eirik
Surgical Department, Haraldsplass Deaconess Hospital, PB 6165, 5152, Bergen, Norway.
Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2067-2072. doi: 10.1007/s00167-015-3845-8. Epub 2015 Oct 31.
To evaluate mid- to long-term results after arthroscopic rotator cuff repair and to explore possible predictors of inferior outcome.
Patients treated for full-thickness supraspinatus and/or infraspinatus tears from 2004 to 2008, using a uniform single-row arthroscopic technique, were included in the study. Pre- and post-operative QuickDASH were used as the primary outcome measure, and VAS of pain, function and satisfaction were also collected. An additional questionnaire explored demographic and preoperative factors like onset and duration of symptoms, preoperative treatment and smoking habits.
One hundred and forty-seven patients (82 %) were available at 6-9 years after surgery. All outcomes improved significantly from the preoperative values. A total of 8 % of patients had undergone additional surgery to the same shoulder during the follow-up period. Long-standing symptoms (>12 months) (P < 0.01), non-acute onset of symptoms (P < 0.01) and preoperative use of NSAIDs (P = 0.01) were correlated with inferior outcome at follow-up. No other factors investigated (i.e. gender, age, smoking and steroid injections) were found to affect the primary outcome (QuickDASH).
The current study is one of few reports of mid- to long-term outcomes after arthroscopic single-row repair of full-thickness rotator cuff tears. Global improvement in symptoms and function was found between the preoperative and the 6-9 years evaluation, and the technique therefore seems like a viable approach for treating tears of the supra- and the infraspinatus tendon. Several predictors of inferior long-term outcome after rotator cuff repair were, however, identified: preoperative use of NSAIDs, long-standing symptoms before surgery and non-acute onset of shoulder symptoms. In light of the current findings, accurate diagnosis and prompt treatment seem important in optimizing outcomes after rotator cuff surgery.
IV.
评估关节镜下肩袖修补术后的中长期疗效，并探索预后较差的可能预测因素。
本研究纳入了2004年至2008年采用统一单排关节镜技术治疗全层冈上肌和/或冈下肌撕裂的患者。术前和术后使用QuickDASH作为主要结局指标，同时收集疼痛、功能和满意度的视觉模拟评分（VAS）。另外还通过问卷探究了人口统计学和术前因素，如症状的发作和持续时间、术前治疗及吸烟习惯。
术后6至9年，147例患者（82%）仍可进行评估。所有结局指标较术前均有显著改善。随访期间，共有8%的患者对同一肩部进行了二次手术。长期症状（>12个月）（P<0.01）、非急性症状发作（P<0.01）和术前使用非甾体抗炎药（NSAIDs）（P=0.01）与随访时较差的预后相关。未发现其他研究因素（即性别、年龄、吸烟和类固醇注射）影响主要结局指标（QuickDASH）。
本研究是少数关于关节镜下单排修补全层肩袖撕裂术后中长期疗效的报告之一。术前与6至9年评估之间症状和功能有整体改善，因此该技术似乎是治疗冈上肌和冈下肌腱撕裂的可行方法。然而，确定了肩袖修补术后长期预后较差的几个预测因素：术前使用NSAIDs、手术前长期存在症状以及肩部症状非急性发作。根据目前的研究结果，准确诊断和及时治疗对于优化肩袖手术后的结局似乎很重要。
IV级
