Department of Orthopedic Surgery, Keimyung University School of Medicine, 1035 Dalgubul-ro, Dalseo-gu, Daegu, 42601, South Korea.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2220-2227. doi: 10.1007/s00167-020-06019-z. Epub 2020 Apr 29.
The purposes of this study were to (1) evaluate changes in recovery patterns [i.e., clinical outcomes, range of motion (ROM)] in the first 12 months following surgery, (2) identify potential prognostic factors of early clinical outcomes after rotator cuff repair (RCR).
The study cohort included 344 consecutive patients treated with RCR. Data were collected prospectively and included pre- and perioperative variables. Univariate and multivariate linear regression analyses for various parameters including demographics, pre- and perioperative variables were used to predict shoulder function at 12-month follow-up, as measured by clinical outcomes and ROM.
Significant improvement in all clinical scores and ROM were noted during serial follow-ups after RCR (all p < 0.001). Multivariate analysis revealed that female sex, older age, more anchors, diabetes mellitus, and preoperative stiffness were independently associated with worse shoulder function 3 months after RCR. Including the 3 months factors, heavy labor, use of the suture-bridge technique, and large tears were also independently associated with worse outcomes 6 months after surgery. Heavy labor, suture-bridge technique, diabetes mellitus, and preoperative stiffness were associated with significantly worse functional outcomes at 12 months after surgery (all p < 0.05).
Functional recovery based on clinical outcomes (i.e., UCLA, ASES scores) showed approximately 60% of ultimate recovery at 3 months and approximately 75% recovery at 6 months after RCR. Female sex, diabetes mellitus, preoperative stiffness, a larger number of anchors, suture bridge technique, heavy labor, old age and, larger tears were prognostic factors of poor clinical results or ROM in the short-term follow-up intervals. Knowledge of these prognostic factors may lead to improved insight for physicians to predict the pattern of the recovery and patient expectations accordingly.
III, A cohort study.
本研究旨在：(1)评估术后 12 个月内恢复模式（即临床结果、活动范围[ROM]）的变化；(2)确定肩袖修复（RCR）后早期临床结果的潜在预后因素。
研究队列包括 344 例连续接受 RCR 治疗的患者。数据前瞻性收集，包括术前和围手术期变量。使用单变量和多变量线性回归分析各种参数，包括人口统计学、术前和围手术期变量，以预测 12 个月随访时的肩部功能，采用临床结果和 ROM 进行评估。
RCR 后连续随访时，所有临床评分和 ROM 均显著改善（均 p < 0.001）。多变量分析显示，女性、年龄较大、更多锚钉、糖尿病和术前僵硬与 RCR 后 3 个月肩部功能较差独立相关。包括 3 个月因素在内，重体力劳动、使用缝线桥技术和大撕裂也与术后 6 个月的结果较差独立相关。重体力劳动、缝线桥技术、糖尿病和术前僵硬与术后 12 个月的功能结果显著较差相关（均 p < 0.05）。
基于临床结果（即 UCLA、ASES 评分）的功能恢复，在 RCR 后 3 个月时达到最终恢复的约 60%，6 个月时达到约 75%。女性、糖尿病、术前僵硬、更多锚钉、缝线桥技术、重体力劳动、年龄较大和较大撕裂是短期随访期间临床结果或 ROM 较差的预后因素。了解这些预后因素可能有助于医生更好地预测恢复模式，并相应地调整患者的预期。
III，队列研究。
