Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea.
Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea.
J Shoulder Elbow Surg. 2019 Feb;28(2):237-243. doi: 10.1016/j.jse.2018.07.022. Epub 2018 Oct 15.
Rotator cuff tear and glenohumeral osteoarthritis are 2 common diseases, but there are few studies about their clinical correlation. The purpose of this study was to evaluate the influence of mild glenohumeral osteoarthritis on the clinical outcome after large to massive rotator cuff repair.
This study included 146 patients who underwent rotator cuff repair for large to massive tears and were available for follow-up at a minimum of 2 years. Of the patients, 74 had mild glenohumeral osteoarthritis (group A) and 72 did not have glenohumeral osteoarthritis (group B).
The mean visual analog scale score during motion, mean University of California at Los Angeles score, and mean Constant score were 1.8, 30.2, and 87.4, respectively, in group A and 2.0, 30.8, and 89.2, respectively, in group B at final follow-up. The retear rates were 31.1% (23 of 74 patients) in group A and 25.0% (18 of 72 patients) in group B. The osteoarthritis progression rates were 12.1% (9 of 74) in group A and 13.8% (10 of 72) in group B. However, in group A, the osteoarthritis progression rates were 26.1% (6 of 23) for retear cases and 5.9% (3 of 51) for healed cases. There was a significant difference in the progression rates between retear and healed cases in group A (odds ratio, 5.65; P = .022).
There were no significant differences in clinical outcomes between patients with and without glenohumeral osteoarthritis before surgery and during final follow-up. The progression of osteoarthritis in large to massive rotator cuff tears is relatively low. However, it is significantly higher in patients with retears in whom osteoarthritis is present.
肩袖撕裂和肩峰下骨关节炎是两种常见的疾病，但关于它们的临床相关性研究较少。本研究旨在评估轻度肩峰下骨关节炎对大到巨大肩袖修复后临床结果的影响。
本研究纳入了 146 例接受大到巨大肩袖撕裂修复的患者，并在至少 2 年的时间内进行了随访。其中 74 例患者患有轻度肩峰下骨关节炎（A 组），72 例患者无肩峰下骨关节炎（B 组）。
A 组患者在运动时的平均视觉模拟评分、加州大学洛杉矶分校评分和Constant 评分分别为 1.8、30.2 和 87.4，B 组分别为 2.0、30.8 和 89.2。A 组的再撕裂率为 31.1%（74 例中的 23 例），B 组为 25.0%（72 例中的 18 例）。A 组的骨关节炎进展率为 12.1%（74 例中的 9 例），B 组为 13.8%（72 例中的 10 例）。然而，在 A 组中，再撕裂病例的骨关节炎进展率为 26.1%（23 例中的 6 例），愈合病例为 5.9%（51 例中的 3 例）。A 组中再撕裂和愈合病例的进展率存在显著差异（优势比，5.65；P=0.022）。
在手术前和最终随访时，患有和不患有肩峰下骨关节炎的患者的临床结果没有显著差异。大到巨大肩袖撕裂的骨关节炎进展相对较低。然而，在存在骨关节炎的再撕裂患者中，骨关节炎的进展率显著更高。
