Department of Sports Medicine, Huashan Hospital, No 12, Wulumuqi Zhong Road, Shanghai, 200040, People's Republic of China.
Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):4014-4020. doi: 10.1007/s00167-019-05651-8. Epub 2019 Aug 26.
To assess patients with and without postoperative residual pain and to compare clinical function and magnetic resonance imaging (MRI) appearance of the repaired supraspinatus tendon between patients with and without pain.
One-hundred and seventeen patients with supraspinatus tear were included in this study. Visual Analog Scale (VAS) scores for pain were assessed at a follow-up of at least 1 year. Patients with residual shoulder pain were enrolled in the residual pain group (RP group) and patients without pain enrolled in the no pain group (NP group). The American Shoulder and Elbow Surgeons (ASES) shoulder evaluation form, the modified University of California at Los Angeles (UCLA) score and the Fudan University Shoulder Score (FUSS) were also used to evaluate shoulder function. MRI examinations were performed to evaluate rotator cuff integrity according to the Sugaya method, and muscular hypotrophy, fatty infiltration, and signal/noise quotient (SNQ) of the rotator cuff tendon.
Thirty-five patients had residual pain (RP group) and 82 patients had no pain (NR group). At the final follow-up, there was a significant difference in ASES (92 ± 8 points vs 76 ± 10 points; p < 0.001), UCLA (32 ± 3 points vs 28 ± 3 points; p < 0.001), FUSS (90 ± 7 points vs 80 ± 9 points; p < 0.001) and strength (9 ± 3 kg vs 6 ± 2 kg; p < 0.001) between the NP group and the RP group, respectively. Postoperative MRI revealed that there was no significant difference in the retear rate (9.8% vs 8.6%; ns), the muscular hypotrophy (ns), and the fatty infiltration index (0.9 ± 0.2 vs 0.9 ± 0.2; ns) between the NP and the RP groups, respectively. The postoperative tendon SNQ of the RP group was significantly higher than that of the NP group (4.6 ± 2.5 vs 3 ± 1.7; p < 0.001). There was a significant association between tendon SNQ and VAS for this cohort ([Formula: see text] = 0.29; p = 0.003).
Postoperative residual pain is associated with a high MRI signal intensity of the repaired supraspinatus tendon. Since high signal intensity of tendon tissue indicates degenerated tendon tissue quality, it highlighted the necessity of debriding the degenerated rotator cuff tendon tissue.
III.
评估术后有和无残余疼痛的患者，并比较有和无疼痛患者的修复肩袖的临床功能和磁共振成像（MRI）表现。
本研究纳入了 117 例肩袖撕裂患者。至少随访 1 年后，评估视觉模拟评分（VAS）疼痛评分。有残余肩部疼痛的患者被纳入残余疼痛组（RP 组），无疼痛的患者被纳入无疼痛组（NP 组）。还使用美国肩肘外科医师协会（ASES）肩关节评估表、改良加利福尼亚大学洛杉矶分校（UCLA）评分和复旦大学肩关节评分（FUSS）评估肩关节功能。MRI 检查根据 Sugaya 方法评估肩袖完整性，并评估冈上肌肌腱的萎缩、脂肪浸润和信号/噪声比（SNQ）。
35 例患者有残余疼痛（RP 组），82 例患者无疼痛（NR 组）。末次随访时，两组 ASES（92±8 分比 76±10 分；p<0.001）、UCLA（32±3 分比 28±3 分；p<0.001）、FUSS（90±7 分比 80±9 分；p<0.001）和力量（9±3 kg 比 6±2 kg；p<0.001）均有显著差异。术后 MRI 显示，两组再撕裂率（9.8%比 8.6%；ns）、肌肉萎缩（ns）和脂肪浸润指数（0.9±0.2 比 0.9±0.2；ns）均无显著差异。RP 组术后肌腱 SNQ 明显高于 NP 组（4.6±2.5 比 3±1.7；p<0.001）。该队列中肌腱 SNQ 与 VAS 之间存在显著相关性（[Formula: see text]=0.29；p=0.003）。
术后残余疼痛与修复的冈上肌肌腱的高 MRI 信号强度有关。由于肌腱组织的高信号强度表明变性的肌腱组织质量，这突出了切除变性肩袖肌腱组织的必要性。
III。
