Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Orthopedic Surgery, Hanyang University College of Medicine, Seoul, Korea.
Clin Orthop Surg. 2021 Mar;13(1):88-96. doi: 10.4055/cios20002. Epub 2021 Feb 15.
Rotator cuff tears can be asymptomatic in some cases; however, even when the tear size is small, clinical symptoms can be very severe. This suggests that symptoms of rotator cuff tears are related to factors other than the size. Although synovitis has been cited as one of the factors, there is no grading system for synovitis in rotator cuff tears. Moreover, there are few studies that evaluated the relationship between synovitis and clinical features in patients with rotator cuff tears.
Patients with medium-sized rotator cuff tears, who were scheduled for arthroscopic repair, were recruited for this study. The glenohumeral joint was divided into 4 quarters. Then, vascularity and hypertrophy of the joint were graded in each quarter using a modified scoring system. Clinical assessment was performed preoperatively and at 3 months and 6 months after surgery. Finally, correlation between the severity of synovitis and clinical features was analyzed.
The intraobserver correlation coefficient was 0.815 to 0.918 and the interobserver correlation coefficient was 0.779 to 0.992 for the single measurement. Vascularity was significantly correlated with the range of motion, strength, and constant score within 6 months after surgery. Hypertrophy was correlated with the range of motion within 6 months after surgery.
Synovitis in the shoulder with rotator cuff tears can be graded by using our modified scoring system. The severity of synovitis was closely related to the clinical features after surgery. Therefore, when treating patients with rotator cuff tears, treatment of synovitis should also be considered.
肩袖撕裂在某些情况下可能无症状；然而，即使撕裂较小，临床症状也可能非常严重。这表明肩袖撕裂的症状与撕裂大小以外的因素有关。虽然滑膜炎已被认为是其中的一个因素，但肩袖撕裂中并没有滑膜炎的分级系统。此外，很少有研究评估滑膜炎与肩袖撕裂患者临床特征之间的关系。
本研究招募了计划接受关节镜修复的中等大小肩袖撕裂患者。将盂肱关节分为 4 个象限。然后，使用改良评分系统对每个象限的关节血管生成和肥大进行分级。在术前和术后 3 个月和 6 个月进行临床评估。最后，分析滑膜炎严重程度与临床特征之间的相关性。
对于单次测量，观察者内相关系数为 0.815 至 0.918，观察者间相关系数为 0.779 至 0.992。术后 6 个月内，血管生成与运动范围、力量和持续评分显著相关。肥大与术后 6 个月内的运动范围相关。
可以使用我们改良的评分系统对肩袖撕裂伴滑膜炎的肩进行分级。滑膜炎的严重程度与术后的临床特征密切相关。因此，在治疗肩袖撕裂患者时，也应考虑滑膜炎的治疗。
