Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA.
Steadman Philippon Research Institute, Vail, CO, USA.
J Shoulder Elbow Surg. 2022 Mar;31(3):616-622. doi: 10.1016/j.jse.2021.08.007. Epub 2021 Sep 1.
Outcomes following arthroscopic excision of calcific tendonitis and arthroscopic rotator cuff repair (CT-ARCR) are relatively limited without comparison analysis to standard arthroscopic rotator cuff repair (ARCR). The purpose of this study was to evaluate patient-reported outcomes (PROs) after CT-ARCR compared against a matched cohort who received standard ARCR.
An institutional review board-approved retrospective review was performed for patients aged 18-80 years receiving CT-ARCR by a single surgeon from 2006-2018. These were matched 1:3 with patients receiving ARCR. Patients with concurrent labral repair, subscapularis repair, or glenohumeral joint arthritis procedures; refusal to participate; deceased; inadequate contact information; or those with inadequate records were excluded. PROs included Short Form-12 Physical Component Summary (SF-12 PCS) score; American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES); Single Assessment Numeric Evaluation (SANE); Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH); patient satisfaction; activity level/symptoms; and sport participation scores.
21 CT-ARCR patients (mean age 50 years, range 36-62) and 54 ARCR patients (mean age 52 years, range 19-77) were included. Minimum 2-year follow-up was obtained in 18 of 21 (86%) CT-ARCR (mean 5.9 years) and 45 of 54 (83%) ARCR patients (mean 5.6 years). CT-ARCR patients improved pre- to postoperation in mean SF-12 PCS (41.1 to 50.0), ASES (54.2 to 94.0), and QuickDASH (54.2 to 94.0). SANE score improvements (57.6 to 82.8) were not significant. ARCR controls improved pre- to postoperation in mean SF-12 PCS (41.4 to 49.0), ASES (59.4 to 88.0), QuickDASH (35.1 to 13.8), and SANE scores (52.6 to 80.8). Pre- to postoperative pain during recreation and sport participation similarly improved in both groups. The only postoperative difference observed between CT-ARCR and ARCR was better patient satisfaction with CT-ARCR (9.7 vs. 8.3).
CT-ARCR results in excellent PROs, activity symptoms, and sports participation at final follow-up. CT-ARCR results were comparable to patients who received conventional ARCR for similar-sized rotator cuff tears that did not have calcific tendonitis.
在没有与标准关节镜肩袖修复术(ARCR)进行比较分析的情况下,关节镜下切除钙化性肌腱炎和关节镜下肩袖修复术(CT-ARCR)的结果相对有限。本研究的目的是评估与接受标准 ARCR 的匹配队列相比,CT-ARCR 后的患者报告结果(PRO)。
对 2006 年至 2018 年间由一名外科医生进行 CT-ARCR 的 18-80 岁患者进行了机构审查委员会批准的回顾性研究。这些患者与接受 ARCR 的患者按 1:3 匹配。患有同期盂唇修复、肩胛下肌修复或肩关节炎手术、拒绝参与、死亡、联系方式不完整或记录不完整的患者被排除在外。PRO 包括 12 项简短表格物理成分综合评分(SF-12 PCS);美国肩肘外科医生协会标准化肩部评估表(ASES);单一评估数值评估(SANE);快速上肢肩部和手部问卷(QuickDASH);患者满意度;活动水平/症状;和运动参与评分。
共纳入 21 例 CT-ARCR 患者(平均年龄 50 岁,范围 36-62 岁)和 54 例 ARCR 患者(平均年龄 52 岁,范围 19-77 岁)。21 例 CT-ARCR 患者中的 18 例(86%)(平均 5.9 年)和 54 例 ARCR 患者中的 45 例(83%)(平均 5.6 年)获得了至少 2 年的随访。CT-ARCR 患者的 SF-12 PCS(41.1 至 50.0)、ASES(54.2 至 94.0)和 QuickDASH(54.2 至 94.0)评分均有显著改善。SANE 评分改善(57.6 至 82.8)不显著。ARCR 对照组的 SF-12 PCS(41.4 至 49.0)、ASES(59.4 至 88.0)、QuickDASH(35.1 至 13.8)和 SANE 评分(52.6 至 80.8)在术前至术后均有显著改善。两组患者在娱乐和运动参与期间的术后疼痛均有相似的改善。CT-ARCR 和 ARCR 之间唯一的术后差异是 CT-ARCR 的患者满意度更高(9.7 比 8.3)。
CT-ARCR 最终随访的 PRO、活动症状和运动参与度均良好。CT-ARCR 的结果与接受类似大小肩袖撕裂但无钙化性肌腱炎的常规 ARCR 患者的结果相当。