Watson Scott, Allen Benjamin, Robbins Chris, Bedi Asheesh, Gagnier Joel J, Miller Bruce
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.
Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Orthop J Sports Med. 2018 Mar 27;6(3):2325967118763107. doi: 10.1177/2325967118763107. eCollection 2018 Mar.
Limited literature exists regarding the influence of rotator cuff tear morphology on patient outcomes.
To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair.
Cohort study; Level of evidence, 3.
Patients undergoing arthroscopic repair of known full-thickness rotator cuff tears were observed prospectively at regular intervals from baseline to 1 year. The tear pattern was classified at the time of surgery as crescent, U-shaped, or L-shaped. Primary outcome measures were the Western Ontario Rotator Cuff Index (WORC), the American Shoulder and Elbow Surgeons (ASES), and a visual analog scale (VAS) for pain. The tear pattern was evaluated as the primary predictor while controlling for variables known to affect rotator cuff outcomes. Mixed-methods regression and analysis of variance (ANOVA) were used to examine the effects of tear morphology on patient-reported outcomes after surgical repair from baseline to 1 year.
A total of 82 patients were included in the study (53 male, 29 female; mean age, 58 years [range, 41-75 years]). A crescent shape was the most common tear pattern (54%), followed by U-shaped (25%) and L-shaped tears (21%). There were no significant differences in outcome scores between the 3 groups at baseline. All 3 groups showed statistically significant improvement from baseline to 1 year, but analysis failed to show any predictive effect in the change in outcome scores from baseline to 1 year for the WORC, ASES, or VAS when tear pattern was the primary predictor. Further ANOVA also failed to show any significant difference in the change in outcome scores from baseline to 1 year for the WORC ( = .96), ASES ( = .71), or VAS ( = .86).
Rotator cuff tear pattern is not a predictor of functional outcomes after arthroscopic rotator cuff repair.
关于肩袖撕裂形态对患者预后影响的文献有限。
确定肩袖撕裂模式（新月形、U形、L形）对肩袖修复术后患者报告结局的影响。
队列研究；证据等级，3级。
对接受已知全层肩袖撕裂关节镜修复术的患者从基线到1年进行定期前瞻性观察。手术时将撕裂模式分为新月形、U形或L形。主要结局指标为西 Ontario 肩袖指数（WORC）、美国肩肘外科医师协会（ASES）评分以及疼痛视觉模拟量表（VAS）。在控制已知影响肩袖结局的变量的同时，将撕裂模式作为主要预测因素进行评估。采用混合方法回归和方差分析（ANOVA）来检验撕裂形态对手术修复后从基线到1年患者报告结局的影响。
本研究共纳入82例患者（男性53例，女性29例；平均年龄58岁[范围41 - 75岁]）。新月形是最常见的撕裂模式（54%），其次是U形（25%）和L形撕裂（21%）。三组在基线时的结局评分无显著差异。所有三组从基线到1年均显示出统计学上的显著改善，但当撕裂模式作为主要预测因素时，分析未能显示WORC、ASES或VAS从基线到1年结局评分变化的任何预测作用。进一步的方差分析也未能显示WORC（ = 0.96）、ASES（ = 0.71）或VAS（ = 0.86）从基线到1年结局评分变化的任何显著差异。
肩袖撕裂模式不是关节镜下肩袖修复术后功能结局的预测因素。
