School of Medicine, University of Pittsburgh, 456 South Graham St, Pittsburgh, PA, 15232, USA.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3200 South Water Street, Pittsburgh, PA, 15203, USA.
Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):3951-3955. doi: 10.1007/s00167-021-06652-2. Epub 2021 Jul 13.
The critical shoulder angle (CSA) has been implicated as a potential risk factor for failure following arthroscopic rotator cuff repair (RCR). However, there is conflicting evidence regarding the clinical usefulness of this measurement. Given these discrepancies and limited comparisons to clinical outcomes, the aim of the current study was to determine whether higher CSAs correlated with an increased retear rate after arthroscopic rotator cuff repair and to determine if any association between CSA and patient-reported outcomes (PROs) exists. It was hypothesized that there would be no correlation between CSA and retear rate or PROs after arthroscopic rotator cuff repair.
A total of 164 patients who underwent arthroscopic RCR were retrospectively reviewed. CSA was measured for each patient. Patients were then divided into a retear group of 18 patients and a non-retear group of 146 patients. Patient-reported outcomes (PROs), including PROMIS 10 score, American Shoulder and Elbow Surgeons (ASES) score, Brophy score, and visual analog pain scores (VAS) were recorded post-operatively.
The average CSA was 31.2 ± 4.5° for the retear group and 32.2 ± 4.7° for the non-retear group (n.s.). No correlations were found between CSA and PROMIS score (n.s.), ASES score (n.s.), Brophy score (n.s.), or VAS (n.s.).
Critical shoulder angle had no correlation to retear rate or patient-reported outcomes. CSA should not be used as a clinical predictor to assess rotator cuff retear risk after arthroscopic RCR.
Level III.
临界肩角（CSA）已被认为是关节镜下肩袖修复（RCR）后失败的潜在危险因素。然而，关于该测量的临床实用性存在相互矛盾的证据。鉴于这些差异以及与临床结果的有限比较，本研究旨在确定关节镜下肩袖修复后 CSA 是否与更高的再撕裂率相关，并确定 CSA 是否与患者报告的结果（PROs）之间存在任何关联。假设 CSA 与关节镜下肩袖修复后的再撕裂率或 PROs 之间不存在相关性。
回顾性分析了 164 例接受关节镜 RCR 的患者。测量每位患者的 CSA。然后，将患者分为再撕裂组（18 例）和非再撕裂组（146 例）。记录患者报告的结果（PROs），包括 PROMIS 10 评分、美国肩肘外科医生（ASES）评分、Brophy 评分和视觉模拟疼痛评分（VAS）。
再撕裂组的平均 CSA 为 31.2±4.5°，非再撕裂组为 32.2±4.7°（无统计学差异）。CSA 与 PROMIS 评分（无统计学差异）、ASES 评分（无统计学差异）、Brophy 评分（无统计学差异）或 VAS（无统计学差异）之间均无相关性。
临界肩角与再撕裂率或患者报告的结果无关。CSA 不应作为评估关节镜下 RCR 后肩袖再撕裂风险的临床预测指标。
III 级。
