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关节镜肩袖修复术后需要手术干预的术后僵硬与患者相关的危险因素。

Patient-related Risk Factors for Postoperative Stiffness Requiring Surgical Intervention After Arthroscopic Rotator Cuff Repair.

机构信息

From the Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA.

出版信息

J Am Acad Orthop Surg. 2019 Apr 1;27(7):e319-e323. doi: 10.5435/JAAOS-D-16-00929.

Abstract

INTRODUCTION

Risk factors for stiffness after arthroscopic rotator cuff repair (RCR) have been limited to studies with small patient numbers. The objective is to determine patient-related risk factors for stiffness after RCR.

METHODS

The PearlDiver database was queried from 2007 to 2015 for patients undergoing isolated arthroscopic RCR. A multivariate binomial logistic regression analysis assessed for risk factors requiring a postoperative manipulation under anesthesia (MUA) or lysis of adhesions (LOA) within 9 months after RCR.

RESULTS

Two hundred thirty-two of 19,229 patients (1.2%) underwent a LOA and/or MUA within 9 months after arthroscopic RCR. Significant risk factors identified were age less than 50 years (odds ratio [OR], 1.9; P < 0.0001), female gender (OR, 2.0; P < 0.0001), diabetes mellitus (DM) type I (OR, 2.7; P < 0.0001), hypothyroidism (OR, 1.3; P = 0.020), and systemic lupus erythematosus (OR, 2.1; P = 0.004). However, tobacco use was associated with a 0.5 risk of developing stiffness (P < 0.0001).

DISCUSSION

Systemic lupus erythematosus, hypothyroidism, and DMI (but not DMII) in addition to young age and female gender were risk factors for LOA/MUA after arthroscopic RCR.

摘要

简介

关节镜肩袖修复(RCR)后僵硬的风险因素仅限于少数患者的研究。目的是确定 RCR 后僵硬的患者相关风险因素。

方法

2007 年至 2015 年,PearlDiver 数据库对接受单纯关节镜 RCR 的患者进行了查询。多元二项逻辑回归分析评估了 RCR 后 9 个月内需要接受麻醉下手法复位(MUA)或粘连松解术(LOA)的风险因素。

结果

在 19229 例患者中,有 232 例(1.2%)在 RCR 后 9 个月内行 LOA 和/或 MUA。确定的显著风险因素为年龄小于 50 岁(比值比[OR],1.9;P <0.0001)、女性(OR,2.0;P <0.0001)、I 型糖尿病(OR,2.7;P <0.0001)、甲状腺功能减退(OR,1.3;P =0.020)和系统性红斑狼疮(OR,2.1;P =0.004)。然而,吸烟与僵硬风险降低 0.5 相关(P <0.0001)。

讨论

除了年轻和女性性别外,系统性红斑狼疮、甲状腺功能减退和 I 型糖尿病也是关节镜 RCR 后 LOA/MUA 的危险因素。

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