Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Incheon, Republic of Korea.
J Shoulder Elbow Surg. 2018 Jun;27(6):1012-1020. doi: 10.1016/j.jse.2017.11.016. Epub 2017 Dec 29.
We wished to identify the preoperative prognostic factors associated with structural integrity after repair of medium-sized and larger rotator cuff tears and to determine the cutoff values using receiver operating characteristic curve analysis.
The study included 180 patients with medium-sized and larger rotator cuff tears. Each had a minimum 2-year postoperative follow-up by magnetic resonance imaging. We assessed several patient-related and disease-related preoperative factors using univariate and multivariate logistic regression analysis. To determine the cutoff value for the significant variables, receiver operating characteristic curve analysis was performed.
Retears occurred in 28 of the 180 patients (15.6%). Univariate analysis found that retear was significantly affected by the type of work and pattern of tear. The rate of retear was significantly increased in diabetes and with increasing tear size, extent of retraction, delamination, and fatty infiltration. Furthermore, reduced remnant tendon length, distance from the musculotendinous junction to the face of the glenoid, occupation ratio, and acromiohumeral interval were also significant risk factors. In the multivariate analysis, body mass index, diabetes, dyslipidemia, extent of retraction, delamination, distance from musculotendinous junction to face of glenoid, occupation ratio, fatty infiltration of infraspinatus, and acromiohumeral interval remained significant risk factors. The extent of retraction (22.2 mm) and the occupation ratio (53.5%) showed highly accurate cutoff values for predicting retear.
Multiple factors influenced the healing process after rotator cuff repair. The best predictors were the extent of retraction and occupation ratio, which could help assist in determining the prognosis after rotator cuff repairs.
我们希望确定与中型和大型肩袖撕裂修复后结构完整性相关的术前预测因素，并通过接受者操作特征曲线分析确定截断值。
该研究纳入了 180 例中型和大型肩袖撕裂患者。所有患者均在术后至少 2 年接受了磁共振成像随访。我们使用单变量和多变量逻辑回归分析评估了几种与患者相关和疾病相关的术前因素。为了确定有意义变量的截断值，进行了接受者操作特征曲线分析。
180 例患者中有 28 例（15.6%）发生再撕裂。单变量分析发现，再撕裂与工作类型和撕裂类型显著相关。糖尿病和撕裂大小、回缩程度、分层和脂肪浸润的增加显著增加了再撕裂的发生率。此外，残余肌腱长度减少、肩袖肌腱止点到关节盂前缘的距离、占据比和肩峰肱骨头间距也是显著的危险因素。在多变量分析中，体重指数、糖尿病、血脂异常、回缩程度、分层、肩袖肌腱止点到关节盂前缘的距离、占据比、冈下肌脂肪浸润和肩峰肱骨头间距仍然是显著的危险因素。回缩程度（22.2mm）和占据比（53.5%）对预测再撕裂具有高度准确的截断值。
多种因素影响肩袖修复后的愈合过程。最佳预测因素是回缩程度和占据比，这有助于确定肩袖修复后的预后。
