Cigolotti Augusto, Biz Carlo, Lerjefors Erik, de Iudicibus Gianfranco, Belluzzi Elisa, Ruggieri Pietro
Orthopaedic and Traumatology Clinic, Department of Surgery, Oncology and Gastroenterology DiSCOG, University of Padua, Padova, Italy.
Orthopaedic Clinic, NU Hospital Group, NÄL Hospital Trollhättan and Uddevalla Hospital, Trollhättan, Sweden.
Arch Med Sci. 2020 Jul 28;17(5):1351-1364. doi: 10.5114/aoms.2020.97714. eCollection 2021.
The purpose of this study was twofold. First, the efficacy of arthroscopic repair in patients with full thickness, isolated subscapularis tendon tears (I-STTs) or combined subscapularis tendon tears (C-STTs) involving the rotator cuff tendons was evaluated. Second, the outcomes between these two groups were compared. The influence of age and gender on the cohort clinical outcomes was also analysed. Our hypothesis was that satisfactory functional results could be obtained arthroscopically in both groups without any influence of age or gender.
Seventy-nine patients were enrolled: 15 with I-STTs and 64 with C-STTs. The clinical outcomes were assessed using Constant and Disabilities of the Arm, Shoulder and Hand (DASH) scores, Numeric Rating Scale (NRS) for pain and Visual Analogue Scale (VAS) for satisfaction. The subscapularis strength was assessed using a comparative dynamometric bear-hug test. Group outcomes were compared, including statistical analysis.
For each group, there were no differences regarding the subscapularis strength of the operated and non-operated shoulders. A comparison of the post- with the pre-operative outcomes showed an increase in the Constant score and a decrease in the NRS. Comparing the two groups, we found no difference in strength of the operated and non-operated shoulders, but a significant difference in relation to pre-operative Constant score and pre-operative NRS. Age was negatively correlated with both pre-operative and post-operative Constant scores. No association was found between gender and the outcomes, although the DASH score was higher in women.
Arthroscopic repair of STTs provided functional restoration, pain relief and patient satisfaction in both groups. Age and gender did not affect the clinical outcomes achieved by arthroscopic STT repair.
本研究有两个目的。其一,评估关节镜下修复对全层孤立肩胛下肌腱撕裂(I-STT)患者或合并肩袖肌腱的肩胛下肌腱撕裂(C-STT)患者的疗效。其二,比较这两组患者的治疗结果。同时分析年龄和性别对队列临床结果的影响。我们的假设是,两组患者均可通过关节镜获得满意的功能结果,且不受年龄或性别的影响。
纳入79例患者,其中15例为I-STT,64例为C-STT。使用Constant评分、手臂、肩部和手部功能障碍(DASH)评分、疼痛数字评定量表(NRS)和满意度视觉模拟量表(VAS)评估临床结果。采用比较测力计抱熊试验评估肩胛下肌力量。比较两组结果,包括进行统计分析。
每组中,手术侧与非手术侧肩部的肩胛下肌力量无差异。术前与术后结果比较显示,Constant评分增加,NRS评分降低。比较两组发现,手术侧与非手术侧肩部力量无差异,但术前Constant评分和术前NRS有显著差异。年龄与术前和术后Constant评分均呈负相关。未发现性别与结果之间存在关联,尽管女性的DASH评分较高。
关节镜下修复STT在两组患者中均实现了功能恢复、疼痛缓解和患者满意度。年龄和性别不影响关节镜下STT修复的临床结果。