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肩部骨关节炎的进展:小切口肩袖修复术后的长期随访

Osteoarthritis progression of the shoulder: A long-term follow-up after mini-open rotator cuff repair.

作者信息

Matsuba Tomoyuki, Hata Yukihiko, Ishigaki Norio, Nakamura Koichi, Kato Hiroyuki

机构信息

1 Shoulder Medical Center, North Alps Medical Center Azumi Hospital, Nagano, Japan.

2 Department of Orthopaedic Surgery, Shinshu University School of Medicine, Nagano, Japan.

出版信息

J Orthop Surg (Hong Kong). 2018 May-Aug;26(2):2309499018768106. doi: 10.1177/2309499018768106.

Abstract

OBJECTIVE

This study aimed to investigate whether (1) the primary repair of rotator cuff tears can prevent the progression of osteoarthritis (OA) and (2) the quality of postoperative cuff integrity affects the incidence of osteoarthritic changes.

METHODS

A total of 86 patients treated with mini-open repair for rotator cuff tears over a minimum of 10 years of follow-up (mean ± standard deviation 11.1 ± 1.0 years) were retrospectively analyzed. Preoperative and postoperative radiographs of the affected and unaffected sides were compared, and the degree of OA was evaluated using the Samilson and Prieto classification. Magnetic resonance imaging was used to evaluate cuff integrity, classify patients into good and poor cuff integrity groups, and compare the degree of OA between the two groups.

RESULTS

OA deteriorated either significantly or to a similar degree on both sides postoperatively. However, OA progressed in significantly more cases on the affected side. A comparison between the aforementioned cuff integrity groups showed that the postoperative OA of the poor cuff integrity group was significantly worse than that of the good cuff integrity group on the affected side.

CONCLUSION

Our study showed that even if rotator cuff tears are repaired, the progression of osteoarthritic changes cannot be halted. The progression of OA was affected by cuff integrity. Rotator cuff dysfunction due to poor cuff integrity was a risk factor for shoulder arthritis.

摘要

目的

本研究旨在调查(1)肩袖撕裂的一期修复能否预防骨关节炎(OA)的进展,以及(2)术后肩袖完整性的质量是否会影响骨关节炎变化的发生率。

方法

回顾性分析了86例接受小切口修复肩袖撕裂且随访至少10年(平均±标准差为11.1±1.0年)的患者。比较患侧和未患侧术前及术后的X线片,并使用萨米尔森和普列托分类法评估OA的程度。采用磁共振成像评估肩袖完整性,将患者分为肩袖完整性良好组和不良组,并比较两组之间的OA程度。

结果

术后两侧OA均显著恶化或程度相似。然而,患侧OA进展的病例明显更多。上述肩袖完整性组之间的比较显示,肩袖完整性不良组患侧术后的OA明显比肩袖完整性良好组更严重。

结论

我们的研究表明,即使修复了肩袖撕裂,骨关节炎变化的进展也无法停止。OA的进展受肩袖完整性的影响。肩袖完整性差导致的肩袖功能障碍是肩关节关节炎的一个危险因素。

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