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与症状性肩袖撕裂相关的因素:肩袖结局工作组队列研究。

Factors Associated With Symptomatic Rotator Cuff Tears: The Rotator Cuff Outcomes Workgroup Cohort Study.

机构信息

From the Vanderbilt University School of Medicine, Nashville, Tennessee (AZG); Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (AS, NBJ); Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee (PK); Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (GDA, JEK, NBJ); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee (GDA); King Edward Memorial Hospital, Hamilton, Bermuda (LDH); Orthopedic Institute of Sioux Falls, Sioux Falls, South Dakota (KMB); Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (EM); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ).

出版信息

Am J Phys Med Rehabil. 2021 Apr 1;100(4):331-336. doi: 10.1097/PHM.0000000000001684.

Abstract

OBJECTIVE

Although rotator cuff tear is one of the most common musculoskeletal disorders, its etiology is poorly understood. We assessed factors associated with the presence of rotator cuff tears in a cohort of patients with shoulder pain.

DESIGN

From February 2011 to July 2016, a longitudinal cohort of patients with shoulder pain was recruited. Patients completed a detailed questionnaire in addition to a magnetic resonance imaging scan and a clinical shoulder evaluation. The association of multiple factors associated with rotator cuff tears was assessed using multivariate logistic regression.

RESULTS

In our cohort of 266 patients, 61.3% of patients had a rotator cuff tear. Older age (per 1 yr: odds ratio = 1.03, 95% confidence interval = 1.02-1.07), involvement of the dominant shoulder (odds ratio = 2.02, 95% confidence interval = 1.16-3.52), and a higher body mass index (per 1 kg/m2: odds ratio = 1.06, 95% confidence interval = 1.03-1.12) were independently associated with rotator cuff tears. Sex, depression, smoking status, shoulder use at work, hypertension, and diabetes were not significantly associated with rotator cuff tear.

CONCLUSIONS

In a cohort of patients with shoulder pain, we identified older age, involvement of the dominant shoulder, and a higher body mass index to be independently associated with rotator cuff tear. The mechanism of how these factors possibly lead to rotator cuff tears needs further research.

TO CLAIM CME CREDITS

Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.

CME OBJECTIVES

Upon completion of this article, the reader should be able to: (1) Identify factors associated with an increased risk of developing rotator cuff tears in adults; (2) Describe the current epidemiological trends of rotator cuff tears in the United States; and (3) Discuss the pathophysiological role of aging in the development of nontraumatic rotator cuff tears.

LEVEL

Advanced.

ACCREDITATION

The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

摘要

目的

肩袖撕裂是最常见的肌肉骨骼疾病之一,但病因尚不清楚。我们评估了患有肩痛的患者队列中与肩袖撕裂存在相关的因素。

设计

从 2011 年 2 月至 2016 年 7 月,招募了患有肩痛的纵向队列患者。除了磁共振成像扫描和临床肩部评估外,患者还完成了详细的问卷。使用多变量逻辑回归评估与肩袖撕裂相关的多种因素的关联。

结果

在我们的 266 名患者队列中,61.3%的患者有肩袖撕裂。年龄每增加 1 岁(比值比=1.03,95%置信区间=1.02-1.07)、优势肩受累(比值比=2.02,95%置信区间=1.16-3.52)和较高的体重指数(每增加 1kg/m2:比值比=1.06,95%置信区间=1.03-1.12)与肩袖撕裂独立相关。性别、抑郁、吸烟状况、工作中使用肩部、高血压和糖尿病与肩袖撕裂无显著相关性。

结论

在患有肩痛的患者队列中,我们发现年龄较大、优势肩受累和较高的体重指数与肩袖撕裂独立相关。这些因素如何导致肩袖撕裂的机制需要进一步研究。

索取 CME 学分:完成在线自我评估活动和评估http://www.physiatry.org/JournalCME。

CME 目标:完成本文后,读者应能够:(1)确定与成年人肩袖撕裂风险增加相关的因素;(2)描述美国肩袖撕裂的当前流行病学趋势;(3)讨论衰老在非创伤性肩袖撕裂发展中的病理生理作用。

级别

高级。

认可

学术物理治疗医师协会由继续医学教育认证委员会认可,为医生提供继续医学教育。学术物理治疗医师协会将这项基于期刊的 CME 活动指定为最多 1.0 个 AMA PRA 类别 1 学分(™)。医生只能要求与其参与活动程度相符的学分。

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