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关节镜下肩袖修补术后有无再破裂患者的长期预后

Long-term prognoses of patients with and without re-rupture after arthroscopic rotator cuff repair.

作者信息

Saito Kazuo, Kenmoku Tomonori, Hirota Kyoko, Matsui Hirotaka

机构信息

Department of Rehabilitation, Faculty of Health Sciences, Tokyo Kasei University: 2-15-1 Inariyama, Sayama, Saitama 350-1398, Japan.

Department of Orthopaedic Surgery, Kitasato University School of Medicine, Japan.

出版信息

J Phys Ther Sci. 2021 Jun;33(6):460-465. doi: 10.1589/jpts.33.. Epub 2021 Jun 18.

Abstract

[Purpose] We followed-up patients who underwent arthroscopic rotator cuff repair (ARCR) for 2 years to assess the prognosis of rotator cuff tears and compared the outcomes of the patients with and without re-rupture. We also examined the usefulness of Shoulder36, a self-assessment tool, for assessing the long-term prognosis in patients undergoing ARCR. [Participants and Methods] We included 28 patients who received occupational therapy pre- and post-ARCR between April 2012 and August 2015 and categorized them based on the occurrence of re-rupture. We followed-up on their prognoses for 2 years using physical examination and Shoulder36 assessment. [Results] Re-rupture occurred in five patients within 3 months of treatment. During the 2 year follow-up, the control group showed a significant improvement in pain and bi-directional active range of motion during physical assessment and in five out of six domains during Shoulder36 assessment. In contrast, the re-rupture group showed significant differences for only three domains of the Shoulder36 assessment twelve months after surgery. [Conclusion] We confirmed the long-term functional improvement and maintenance in the re-rupture group, suggesting that continued rehabilitation, compensatory movements, and detailed guidance on daily life activities are required for patients after ARCR. Furthermore, Shoulder36 can be useful for assessing the prognosis of patients with and without re-rupture.

摘要

[目的] 我们对接受关节镜下肩袖修复术(ARCR)的患者进行了2年的随访,以评估肩袖撕裂的预后,并比较了发生再撕裂和未发生再撕裂患者的结果。我们还研究了自我评估工具Shoulder36在评估接受ARCR患者长期预后方面的实用性。[参与者和方法] 我们纳入了2012年4月至2015年8月期间在ARCR术前和术后接受职业治疗的28例患者,并根据再撕裂的发生情况进行分类。我们通过体格检查和Shoulder36评估对他们的预后进行了2年的随访。[结果] 5例患者在治疗后3个月内发生再撕裂。在2年的随访期间,对照组在体格评估中的疼痛和双向主动活动范围以及在Shoulder36评估的六个领域中的五个领域均有显著改善。相比之下,再撕裂组在术后12个月时仅在Shoulder36评估的三个领域存在显著差异。[结论] 我们证实了再撕裂组的长期功能改善和维持,这表明ARCR术后患者需要持续的康复治疗、代偿性运动以及关于日常生活活动的详细指导。此外,Shoulder36可用于评估发生和未发生再撕裂患者的预后。

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