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关节镜下修复 75 岁以上肩袖撕裂的临床中期结果。

Clinical midterm results of arthroscopic rotator cuff repair in patients older than 75 years.

机构信息

Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin, Berlin, Germany.

Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin, Berlin, Germany.

出版信息

J Shoulder Elbow Surg. 2020 Sep;29(9):1815-1820. doi: 10.1016/j.jse.2020.01.093. Epub 2020 Mar 4.

Abstract

BACKGROUND

The effect of patient age on functional improvement after arthroscopic rotator cuff repair (ARCR) is still a matter of debate. The purpose of this study was to evaluate the clinical midterm results after ARCR in patients who were 75 years or older at the time of surgery.

METHODS

A total of 31 shoulders in 30 patients older than 75 years at the time of surgery underwent ARCR for a degenerative full-thickness rotator cuff tear (RCT) between 2010 and 2016. Among those, 23 shoulders in 22 patients (74%) with a mean age at time of surgery of 77 ± 2 years (range, 75-82 years) were followed up after a mean of 7 ± 2 years (range, 3-9 years). Clinical assessment included the Western Ontario Rotator Cuff (WORC) index as well as patient satisfaction, the Subjective Shoulder Value (SSV), Simple Shoulder Test (SST), and the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) score.

RESULTS

Overall, patient satisfaction was excellent, as everybody stated to be very satisfied with the surgery. Neither any complication nor revision surgery occurred during the study period. At final follow-up, the mean WORC index was 88% ± 15%. The mean SSV was comparable between the affected shoulder (90% ± 15%) and the contralateral side (87% ± 15%) (P = .235). The mean SST score was 10 ± 2 points and the mean ASES score was 89 ± 17 points.

CONCLUSION

ARCR for symptomatic RCTs without advanced muscle degeneration in patients older than 75 years at the time of surgery provided good clinical results and high patient satisfaction at midterm follow-up.

摘要

背景

患者年龄对关节镜下肩袖修复(ARCR)后功能改善的影响仍存在争议。本研究旨在评估 75 岁及以上患者接受 ARCR 治疗退行性全层肩袖撕裂(RCT)的临床中期结果。

方法

2010 年至 2016 年间,30 名 75 岁及以上的患者共 31 侧接受 ARCR 治疗。其中 22 例(74%)23 肩(74%)患者在平均 7 ± 2 年(范围 3-9 年)的随访中接受了平均年龄为 77 ± 2 岁(范围 75-82 岁)的随访。临床评估包括 Western Ontario Rotator Cuff(WORC)指数以及患者满意度、主观肩部值(SSV)、简单肩部测试(SST)和美国肩肘外科医生协会标准化肩部评估表(ASES)评分。

结果

总的来说,患者满意度非常高,所有人都对手术非常满意。研究期间无任何并发症或翻修手术发生。最终随访时,WORC 指数平均为 88% ± 15%。患肩的平均 SSV 与对侧相当(90% ± 15%)(P =.235)。平均 SST 评分为 10 ± 2 分,平均 ASES 评分为 89 ± 17 分。

结论

对于 75 岁及以上患者,在无高级肌肉退化的情况下,对于有症状的 RCT 进行 ARCR 手术,可在中期随访中提供良好的临床效果和高患者满意度。

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