Orthopedics. 2020 Nov 1;43(6):340-344. doi: 10.3928/01477447-20200923-02. Epub 2020 Oct 1.
The purpose of this study was to determine the association between time from the diagnosis of rotator cuff tear to repair and the rate of subsequent revision surgery for re-tear. A national insurance database was queried from 2007 to 2016 for patients who underwent arthroscopic rotator cuff repair after a diagnosis of rotator cuff tear with minimum 5-year follow-up. On the basis of time from diagnosis to repair, patients were stratified into an early (<6 weeks), a routine (between 6 weeks and 12 months), or a delayed (>12 months) repair cohort. The rates of subsequent revision rotator cuff repair were compared pairwise between cohorts with Pearson's chi-square tests. Multivariate logistic regression was used to adjust for patient demographics and comorbidity burden. A total of 2759 patients were included, with 1510 (54.7%) undergoing early repair, 1104 (40.0%) undergoing routine repair, and 145 (5.3%) having delayed repair. The overall revision rate at 5-year follow-up was 9.6%. The revision rate was higher in the delayed group (15.2%) relative to the early (9.9%) and routine (8.3%) groups (P=.048 and P=.007, respectively). On multivariate analysis, delayed repair was associated with increased odds of revision surgery (odds ratio, 1.97; P=.009) compared with routine repair. Delayed rotator cuff repair beyond 12 months of diagnosis was associated with an increased risk of undergoing subsequent revision rotator cuff repair while controlling for age and comorbidity burden. [Orthopedics. 2020;43(6):340-344.].
本研究旨在确定肩袖撕裂诊断后至修复时间与再撕裂后再次修复手术率之间的关系。本研究通过国家保险数据库，对 2007 年至 2016 年间接受关节镜下肩袖修复术的肩袖撕裂患者进行了回顾性分析，这些患者的随访时间至少为 5 年。根据诊断至修复的时间，患者被分为早期（<6 周）、常规（6 周至 12 个月）或延迟（>12 个月）修复队列。采用 Pearson 卡方检验比较组间的再次修复肩袖修复率。采用多变量逻辑回归调整患者的人口统计学和合并症负担。共纳入 2759 例患者，其中 1510 例（54.7%）行早期修复，1104 例（40.0%）行常规修复，145 例（5.3%）行延迟修复。5 年随访时的总体翻修率为 9.6%。延迟修复组（15.2%）的翻修率明显高于早期（9.9%）和常规（8.3%）修复组（P=.048 和 P=.007）。多变量分析显示，与常规修复相比，延迟修复与翻修手术的几率增加相关（比值比，1.97；P=.009）。在控制年龄和合并症负担后，诊断后 12 个月以上的延迟肩袖修复与再次接受肩袖修复的风险增加相关。[骨科。2020;43(6):340-344.]。
