Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, U.S.A.
Arthroscopy. 2018 Mar;34(3):754-761. doi: 10.1016/j.arthro.2017.08.248. Epub 2017 Nov 2.
To investigate the influence of pre-existing obesity (body mass index [BMI] ≥ 30) on outcomes after rotator cuff repair surgery.
We collected data on adult patients who underwent surgical repair for symptomatic full-thickness rotator cuff tears confirmed by imaging between 2012 and 2015. The required follow-up was 3 years. At baseline and 6, 12, 24, and 36 months, the American Shoulder and Elbow Surgeons score, Western Ontario Rotator Cuff index, and visual analog scale pain scores were collected. Complications were assessed by a chart review. Obesity was defined as BMI ≥ 30. Chi-square analysis and Student's t-test examined differences between categorical and continuous variables at baseline. Generalized estimating equations examined the effects of fixed factors on outcome variables longitudinally from baseline to 36 months.
Thirty-nine percent of 213 subjects were obese (mean BMI = 29.2; range, 16-48; standard deviation, 5.8). There were no statistically significant differences between obese and nonobese subjects in other baseline characteristics. When controlling for covariates, obese subjects reported no differences in Western Ontario Rotator Cuff, American Shoulder and Elbow Surgeons, or visual analog scale pain scores when compared with nonobese subjects at baseline and over 3 years from surgery. Although obese patients were more likely to have inpatient surgery, there was no difference in the incidence of postoperative complications.
Contrary to our hypothesis, obese participants who underwent rotator cuff repair reported no difference in functional outcome or pain scores compared with nonobese participants over 3 years. In addition, obesity was not associated with postoperative complications in this study. However, as we hypothesized, obese participants were more likely than nonobese participants to have repair in the inpatient setting.
Level III, retrospective comparative study.
研究术前肥胖（体重指数[BMI]≥30）对肩袖修补术后结果的影响。
我们收集了 2012 年至 2015 年间影像学证实的症状性全层肩袖撕裂患者接受手术修复的成人患者数据。需要随访 3 年。在基线和 6、12、24 和 36 个月时，收集美国肩肘外科医生评分、安大略西部肩袖指数和视觉模拟评分疼痛评分。通过病历回顾评估并发症。肥胖定义为 BMI≥30。卡方分析和学生 t 检验用于在基线时检查分类和连续变量之间的差异。广义估计方程从基线到 36 个月纵向检查固定因素对结局变量的影响。
213 名受试者中 39%为肥胖（平均 BMI 为 29.2；范围，16-48；标准差，5.8）。肥胖和非肥胖受试者在其他基线特征方面无统计学差异。在控制协变量后，与非肥胖受试者相比，肥胖受试者在基线和手术 3 年后的 Western Ontario Rotator Cuff、美国肩肘外科医生和视觉模拟评分疼痛方面报告无差异。尽管肥胖患者更有可能接受住院手术，但术后并发症的发生率没有差异。
与我们的假设相反，接受肩袖修复的肥胖参与者在 3 年内与非肥胖参与者在功能结果或疼痛评分方面没有差异。此外，在这项研究中，肥胖与术后并发症无关。然而，正如我们假设的那样，肥胖参与者比非肥胖参与者更有可能在住院环境中进行修复。
III 级，回顾性比较研究。
