Diebold Georgia, Lam Patrick, Walton Judie, Murrell George A C
1Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia.
J Bone Joint Surg Am. 2017 Jul 19;99(14):1198-1205. doi: 10.2106/JBJS.16.00770.
The prevalence of rotator cuff tears increases with age, and many patients undergo surgical repair. Retears are not uncommon, with rates ranging between 9% and 36% in recent studies, and are a major concern. The aim of this study was to investigate the relationship between patient age and the chance of healing following rotator cuff repair.
This was a retrospective cohort study of patients who had undergone arthroscopic rotator cuff repair performed by a single surgeon. All patients had an ultrasound performed by a musculoskeletal sonographer 6 months after rotator cuff repair to assess the repair integrity.
The cohort of 1,600 patients was normally distributed in terms of age, with a mean age (and standard error of the mean) of 59 ± 0.3 years and a range of 15 to 91 years. The 212 patients (13%) who had a retear at 6 months were also normally distributed in terms of age, with a mean age of 65 ± 0.8 years and a range of 15 to 88 years. The retear rate in patients <50 years old was 5%. This increased to 10% in patients aged 50 to 59 years, 15% in those aged 60 to 69 years, 25% in those aged 70 to 79 years, and 34% in those aged ≥80 years. Multiple logistic regression analysis showed that patient age was an independent factor strongly associated with retears.
The rate of rotator cuff retears is low in patients <50 years of age. The relationship between age and rotator cuff retears is linear in patients 50 to 69 years of age, with an increase of 5% between decades, and increases substantially in patients ≥70 years old.
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
肩袖撕裂的患病率随年龄增长而增加,许多患者接受手术修复。再撕裂并不罕见,近期研究中的发生率在9%至36%之间,是一个主要问题。本研究的目的是调查患者年龄与肩袖修复后愈合机会之间的关系。
这是一项对由单一外科医生进行关节镜下肩袖修复的患者的回顾性队列研究。所有患者在肩袖修复后6个月由肌肉骨骼超声检查医师进行超声检查,以评估修复的完整性。
1600例患者的队列在年龄方面呈正态分布,平均年龄(及平均标准误差)为59±0.3岁,范围为15至91岁。6个月时发生再撕裂的212例患者(13%)在年龄方面也呈正态分布,平均年龄为65±0.8岁,范围为15至88岁。年龄<50岁患者的再撕裂率为5%。50至59岁患者的这一比例增至10%,60至69岁患者为15%,70至79岁患者为25%,≥80岁患者为34%。多因素logistic回归分析表明,患者年龄是与再撕裂密切相关的独立因素。
年龄<50岁患者的肩袖再撕裂率较低。50至69岁患者中年龄与肩袖再撕裂之间的关系呈线性,每十年增加5%,而≥70岁患者中这一比例大幅增加。
治疗性IV级。有关证据水平的完整描述,请参阅作者指南。