University of Illinois College of Medicine at Chicago, Chicago, IL, USA.
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Shoulder Elbow Surg. 2022 Aug;31(8):1687-1695. doi: 10.1016/j.jse.2022.01.122. Epub 2022 Feb 25.
Rotator cuff tears have a wide variability in presentation, with some causing pain and reduced function but others remaining completely asymptomatic. Sleep disturbances are a primary driver for patients with rotator cuff tears to see a physician, and one of the main goals of rotator cuff repair (RCR) surgery is to restore normal sleep patterns in these patients. The primary purpose of this study aimed to determine the percentage of patients undergoing RCR who report preoperative sleep disturbances. Second, this study sought to identify at what postoperative follow-up intervals patients stopped reporting sleep disturbances and how the percentages change over time. It was hypothesized that the majority of patients undergoing arthroscopic RCR would report preoperative and initial postoperative sleep disturbances and that 75% of patients would report resolution of sleep disturbances by 1 year postoperatively.
A total of 326 patients undergoing primary arthroscopic RCR were prospectively enrolled in this study. Validated patient-reported outcome measures were obtained preoperatively and postoperatively, including the visual analog pain scale score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation score, Simple Shoulder Test (SST) score, and Veterans RAND 12-Item Health Survey physical and mental component scores.
According to question 2 of the SST, 291 patients (89%) reported preoperative sleep disturbances. Within the cohort of patients who reported resolution of sleep disturbances, 46% reported resolution by 3 months postoperatively; an additional 31%, by 6 months; a further 14%, by 12 months; and the final 8%, by 24 months. Age ≥ 65 years was significantly associated with increased reporting of resolution compared with age < 65 years. All patient-reported outcome measures, including the visual analog pain scale score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation score, SST score, and Veterans RAND 12-Item Health Survey (physical component) score, showed statistically significant improvements after surgery.
Eighty-nine percent of patients reported preoperative sleep disturbances. Seventy-seven percent of patients reported resolution of sleep disturbances by 6 months postoperatively, and 81% of patients reported resolution of sleep disturbances by 2 years postoperatively.
肩袖撕裂的表现差异很大，有些会引起疼痛和功能受限，但有些则完全无症状。睡眠障碍是肩袖撕裂患者就诊的主要原因之一，肩袖修复 (RCR) 手术的主要目标之一是恢复这些患者的正常睡眠模式。本研究的主要目的是确定接受 RCR 的患者中报告术前睡眠障碍的比例。其次，本研究旨在确定术后随访间隔患者停止报告睡眠障碍的时间以及百分比随时间的变化。研究假设接受关节镜 RCR 的大多数患者会报告术前和初始术后睡眠障碍，并且 75%的患者在术后 1 年内会报告睡眠障碍得到解决。
本研究前瞻性纳入了 326 例接受初次关节镜 RCR 的患者。术前和术后均获得了经过验证的患者报告结局测量，包括视觉模拟疼痛评分、美国肩肘外科医生评分、单项评估数值评估评分、简易肩部测试 (SST) 评分以及退伍军人 RAND 12 项健康调查的身体和心理成分评分。
根据 SST 的问题 2，291 例患者 (89%) 报告术前睡眠障碍。在报告睡眠障碍得到解决的患者队列中，46%的患者在术后 3 个月时报告解决；另外 31%的患者在术后 6 个月时报告解决；还有 14%的患者在术后 12 个月时报告解决；最后 8%的患者在术后 24 个月时报告解决。年龄≥65 岁与报告解决的比例增加显著相关，而年龄<65 岁则相反。所有患者报告结局测量，包括视觉模拟疼痛评分、美国肩肘外科医生评分、单项评估数值评估评分、SST 评分以及退伍军人 RAND 12 项健康调查（身体成分）评分，术后均显示出统计学显著改善。
89%的患者报告术前睡眠障碍。77%的患者在术后 6 个月时报告睡眠障碍得到解决，81%的患者在术后 2 年时报告睡眠障碍得到解决。
