Zughaib Marc, Robbins Christopher B, Miller Bruce S, Gagnier Joel J
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
BMJ Open Sport Exerc Med. 2017 Feb 21;2(1):e000209. doi: 10.1136/bmjsem-2016-000209. eCollection 2016.
BACKGROUND/AIM: For patients presenting with glenoid labral pathologies, there is little information on how operative interventions affect long-term outcomes and health-related quality of life (HRQoL). This study evaluated outcomes in operative and non-operative patients presenting with labral tears versus labral degenerations.
Participants completed a pain Visual Analogue Scale (VAS), the Veterans RAND 12-item Health Survey, Western Ontario Rotator Cuff Index, American Shoulder and Elbow Surgeons instrument, Scapular Assistance Test (SAT), Shoulder Activity Level, and Single Assessment Numeric Evaluation at baseline and at 6-month, 12-month and 2-year follow-ups. χand Student's t-test were used to test the differences between categorical and continuous variables. Analysis of variance investigated the differences between groups, and linear regression analyses explored the relationship of baseline characteristics with outcome scores.
After 2 years, the operative cohort (n=68) significantly improved in all measures. The non-operative cohort (n=55) showed significant improvements in all scores except the mental component summary (MCS) and pain VAS. Labral tear patients (n=52) within the operative group (n=28) significantly improved in all measures except MCS. Non-operative labral tear patients (n=24) indicated significant improvements in all measures except MCS, VAS and SAT. Labral degeneration patients (n=71) within the operative group (n=27) significantly improved in all measures except MCS and SAT. Non-operative labral degeneration patients (n=44) indicated significant improvements in all measures except the physical component summary, MCS, VAS and SAT.
Patients who were surgically treated for labral tears or degenerations had significantly improved outcomes and HRQoL scores after 2 years compared with the non-operative cohort.
背景/目的：对于出现盂唇病变的患者，关于手术干预如何影响长期预后和健康相关生活质量（HRQoL）的信息很少。本研究评估了出现盂唇撕裂与盂唇退变的手术和非手术患者的预后。
参与者在基线以及6个月、12个月和2年随访时完成疼痛视觉模拟量表（VAS）、退伍军人兰德12项健康调查、西安大略肩袖指数、美国肩肘外科医师协会器械、肩胛辅助试验（SAT）、肩部活动水平和单项评估数字评价。采用χ检验和学生t检验来检验分类变量和连续变量之间的差异。方差分析研究组间差异，线性回归分析探讨基线特征与结局评分之间的关系。
2年后，手术队列（n = 68）在所有测量指标上均有显著改善。非手术队列（n = 55）除心理成分总结（MCS）和疼痛VAS外，所有评分均有显著改善。手术组（n = 28）中的盂唇撕裂患者（n = 52）除MCS外，所有测量指标均有显著改善。非手术盂唇撕裂患者（n = 24）除MCS、VAS和SAT外，所有测量指标均有显著改善。手术组（n = 27）中的盂唇退变患者（n = 71）除MCS和SAT外，所有测量指标均有显著改善。非手术盂唇退变患者（n = 44）除身体成分总结、MCS、VAS和SAT外，所有测量指标均有显著改善。
与非手术队列相比，接受盂唇撕裂或退变手术治疗的患者在2年后的预后和HRQoL评分有显著改善。
