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孤立型 II 型 SLAP 撕裂更常需要再次手术。

Isolated type II SLAP tears undergo reoperation more frequently.

机构信息

Hand and Arm Center, Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Boston University School of Medicine, Boston, MA, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2021 Aug;29(8):2570-2578. doi: 10.1007/s00167-020-06397-4. Epub 2021 Jan 2.

Abstract

PURPOSE

There is discrepancy in the reported reoperation rate and factors associated with reoperation after type II SLAP repair. The aim was to determine the incidence and factors associated with unplanned reoperation and repair failure after type II SLAP repair.

METHODS

Five-hundred and thiry-nine patients with SLAP repairs were identified from 2005 to 2016. Patient characteristics were recorded and subgroup analyses performed. Multivariable logistic regression was used to identify factors independently associated with unplanned reoperation and SLAP repair failure.

RESULTS

Sixty-six of 539 patients (12%) had unplanned reoperation after SLAP repair. Additional procedures during SLAP repair were associated with fewer unplanned reoperations (OR 0.57; P = 0.046). Age < 40 was associated with unplanned reoperation (55% vs 40%; P = 0.032), but this was not an independent association. Forty-five of 539 patients (8.3%) had SLAP repair failure (defined by repeat SLAP repair or biceps tenodesis/tenotomy). Smoking (OR 3.1; P = 0.004) and knotless suture anchors (OR 3.4; P = 0.007) were associated with SLAP repair failure. Isolated SLAP repair was associated with SLAP repair failure (64% vs 46%; P = 0.020), but this was not an independent association. In those who did not have an isolated SLAP repair, knotless suture anchors (19% vs 3.4%; P = 0.024) were associated with repair failure.

CONCLUSION

After type II SLAP repair, roughly 1 in 10 patients may undergo reoperation. Isolated SLAP repair is independently associated with unplanned reoperation.

LEVEL OF EVIDENCE

Level III.

摘要

目的

关于 II 型 SLAP 修复术后再手术率及相关因素存在争议。本研究旨在确定 II 型 SLAP 修复术后计划性再手术及修复失败的发生率和相关因素。

方法

从 2005 年至 2016 年,共确定了 539 例 SLAP 修复患者。记录患者特征并进行亚组分析。采用多变量逻辑回归分析确定与计划性再手术和 SLAP 修复失败相关的独立因素。

结果

539 例患者中有 66 例(12%)在 SLAP 修复后行计划性再手术。SLAP 修复术中行附加手术与较少的计划性再手术相关(OR 0.57;P=0.046)。<40 岁与计划性再手术相关(55% vs 40%;P=0.032),但这不是独立相关因素。539 例患者中有 45 例(8.3%)发生 SLAP 修复失败(定义为再次行 SLAP 修复或行肱二头肌长头腱切断/固定术)。吸烟(OR 3.1;P=0.004)和无结缝线锚钉(OR 3.4;P=0.007)与 SLAP 修复失败相关。单纯 SLAP 修复与 SLAP 修复失败相关(64% vs 46%;P=0.020),但这不是独立相关因素。在未行单纯 SLAP 修复的患者中,无结缝线锚钉(19% vs 3.4%;P=0.024)与修复失败相关。

结论

在接受 II 型 SLAP 修复术后,约有 10%的患者可能需要再次手术。单纯 SLAP 修复与计划性再手术独立相关。

证据等级

III 级。

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