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影响接受关节镜下肩袖修补术患者重返工作岗位的因素。

Factors Affecting Return to Work in Patients Undergoing Arthroscopic Rotator Cuff Repair.

作者信息

Imai Takaki, Gotoh Masafumi, Hagie Keita, Fukuda Keiji, Ogino Misa, Madokoro Kazuya, Nagamatsu Takashi, Kawakami Junichi, Ohota Toshiyuki, Karasuyama Masaki, Shiba Naoto

机构信息

Kurume University School of Medicine Graduate School, Asahi-machi, Kurume, Fukuoka, Japan.

Department of Rehabilitation, Keishinkai Hospital, Haru-machi, Tosu, Saga, Japan.

出版信息

Prog Rehabil Med. 2019 Feb 16;4:20190006. doi: 10.2490/prm.20190006. eCollection 2019.

Abstract

OBJECTIVE

Although clinical outcomes after arthroscopic rotator cuff repair are generally favorable, postoperative return to work is also an important issue. This study aimed to assess clinical outcomes and clarify the factors affecting return to work in patients who had undergone arthroscopic rotator cuff repair.

METHODS

In total, 63 patients who had undergone arthroscopic rotator cuff repair were included in this study. Clinical assessment was performed using Japanese Orthopaedic Association (JOA) scores, along with measurements of pain, range of motion, muscle strength, cuff integrity, and fatty infiltration. Depending on their return-to-work status at the final follow-up, subjects were assigned to either the complete return group (the patient returned to work) or the incomplete return group (the patient had quit or had changed their occupation at final follow-up). Various clinical parameters affecting the return to work outcome were examined through univariate and multivariate analyses.

RESULTS

Of the 63 subjects, 42 belonged to the complete return group and 21 belonged to the incomplete return group. Therefore, the working capability recovery rate following arthroscopic rotator cuff repair was 66.7%. Both groups showed significant improvement from their preoperative status, but there were statistically significant differences in JOA scores between the groups at 9 and 12 months postoperatively (P <0.01). Multivariate stepwise logistic regression analysis showed that heavy work and female sex were significantly adversely associated with return to work (P <0.05).

CONCLUSION

The working capability recovery rate following arthroscopic rotator cuff repair was 66.7%, and the preoperative factors affecting recovery of working capability were heavy work and female sex.

摘要

目的

尽管关节镜下肩袖修补术后的临床结果总体良好,但术后重返工作岗位也是一个重要问题。本研究旨在评估关节镜下肩袖修补术后患者的临床结果,并阐明影响其重返工作岗位的因素。

方法

本研究共纳入63例行关节镜下肩袖修补术的患者。采用日本骨科协会(JOA)评分进行临床评估,同时测量疼痛、活动范围、肌肉力量、肩袖完整性和脂肪浸润情况。根据最终随访时的重返工作状态,将受试者分为完全重返组(患者重返工作岗位)或不完全重返组(患者在最终随访时已辞职或更换了职业)。通过单因素和多因素分析,研究影响重返工作结果的各种临床参数。

结果

63名受试者中,42名属于完全重返组,21名属于不完全重返组。因此,关节镜下肩袖修补术后的工作能力恢复率为66.7%。两组患者术后均较术前有显著改善,但术后9个月和12个月时,两组间JOA评分存在统计学显著差异(P<0.01)。多因素逐步逻辑回归分析显示,重体力工作和女性性别与重返工作显著负相关(P<0.05)。

结论

关节镜下肩袖修补术后的工作能力恢复率为66.7%,影响工作能力恢复的术前因素为重体力工作和女性性别。

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