University Hospitals of Leicester Leicester General Hospital, Gwendoline Road, Leicester, LE4 5PW, UK.
Eur J Orthop Surg Traumatol. 2022 Feb;32(2):269-277. doi: 10.1007/s00590-021-02962-w. Epub 2021 Apr 3.
The purpose of this study was to determine if delay (before or after 4 months) in repairing a symptomatic traumatic rotator cuff tear affected clinical outcome, re-rupture rates and use of interpositional dermal grafts.
This was a case matched (age + tear size) series of patients who underwent an early (≤ 4 months) or delayed (> 4 months) rotator cuff repair following a traumatic tear. If a direct repair could not be achieved a dermal interposition graft was used. Outcomes were collected at a median time of 30 months post-operatively using the Oxford, Constant and EQ5D scores.
Twenty patients underwent rotator cuff repair within 4 months (1-4) of injury. Twenty age and cuff tear size-matched patients were identified who had undergone a delayed repair (4.1-24 months) after injury. We found no significant difference (p > 0.05) in patient reported outcomes scores between the early and delayed repair. [Oxford scores; Early 43(13-48), Delayed 45 (31-48); Constant scores; Early 73 (21-94), Delayed 73.5 (44-87); EQ5D; Early 0.75 (0.25-1), Delayed 0.77 (0.4-1)]. Time to full recovery was significantly longer (14 vs 33.8 months) for the delayed repair group (P > 0.05). When cuff tears were subdivided into < 3 cm tears or ≥ 3 cm tears, no significant difference outcome scores were founds. However, use of dermal interposition graft was 44% in delayed group for tears ≥ 3 cm. No grafts were used in early repair group. There was one symptomatic re-tear in our series which was in the early repair group.
When compared to the delayed repair group, patients that underwent early repair of traumatic rotator cuff tears had shorter time of recovery, and less need for allograft augmentation for tears 3 cm or greater. However, at mid-term follow-up, this study found no difference in patient reported outcomes following early versus delayed repair of traumatic rotator cuff tears.
本研究旨在确定外伤性肩袖撕裂伤在症状出现后（4 个月之前或之后）进行修复是否会影响临床结果、再撕裂率和使用真皮移植物。
这是一项病例匹配（年龄+撕裂大小）的研究，患者在创伤性肩袖撕裂后接受早期（≤4 个月）或延迟（>4 个月）肩袖修复。如果无法直接修复，则使用真皮间置移植物。在术后中位数 30 个月时，使用牛津、常量和 EQ5D 评分收集结果。
20 例患者在受伤后 4 个月（1-4）内接受肩袖修复。确定了 20 例年龄和肩袖撕裂大小匹配的患者，他们在受伤后 4.1-24 个月进行了延迟修复。我们发现早期和延迟修复之间的患者报告结果评分没有显著差异（p>0.05）。[牛津评分；早期 43（13-48），延迟 45（31-48）；常量评分；早期 73（21-94），延迟 73.5（44-87）；EQ5D；早期 0.75（0.25-1），延迟 0.77（0.4-1）]。延迟修复组的完全恢复时间明显更长（14 与 33.8 个月相比，p>0.05）。当肩袖撕裂分为<3cm 撕裂或≥3cm 撕裂时，未发现显著的结果评分差异。然而，对于≥3cm 的撕裂，延迟组使用真皮间置移植物的比例为 44%。在早期修复组中未使用移植物。在我们的研究中，只有 1 例症状性再撕裂发生在早期修复组。
与延迟修复组相比，早期修复外伤性肩袖撕裂的患者恢复时间更短，对于 3cm 或更大的撕裂，需要同种异体移植物增强的情况更少。然而，在中期随访中，本研究发现早期与延迟修复外伤性肩袖撕裂的患者报告结果无差异。
3 级。
