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糖尿病和肥胖作为慢性肩袖撕裂关节镜修复预后因素

Diabetes Mellitus and Obesity as Prognostic Factors in Arthroscopic Repair of Chronic Rotator Cuff Tears.

作者信息

Álvarez de la Cruz Javier, Méndez Ojeda Marye Mercé, Álvarez Benito Nuria, Herrera Rodríguez Alejandro, Pais Brito Jose Luis, Márquez Marfil Francisco Jesús

机构信息

Orthopedic Surgery and Traumatology Service, University Hospital of the Canary Islands, 38320 La Laguna, Spain.

Orthopedic Surgery Service, Surgery Department, La Laguna University, 38320 La Laguna, Spain.

出版信息

J Clin Med. 2023 Jan 12;12(2):627. doi: 10.3390/jcm12020627.

Abstract

Metabolic diseases such as obesity and diabetes mellitus seem to have an influence on reoperation and long-term functional outcomes after arthroscopic repair of chronic rotator cuff tears. High prevalence of these pathologies can be found in the Canary Islands. A retrospective cohort study was carried out, in which 80 patients undergoing shoulder arthroscopic surgery for the repair of chronic rotator cuff tears were included, with a minimum follow up of 5 years, to study the occurrence of complications, reoperation, and functional outcomes. Functionality after surgery improved in 75% of patients with diabetes and remained the same or worsened in 25% (OR = 1.444). In the group of non-diabetic patients, 83.9% had improved function after surgery while it remained the same or worsened in 16.1% (OR = 0.830). Functionality after surgery improved in 76.6% of obese patients and remained the same or worsened in 23.4% (OR = 1.324). In the non-obese group, 87.9% had improved function after surgery, while it remained the same or worsened in 12.1% (OR = 0.598). Despite not obtaining statistically significant differences, the analysis of the results obtained suggests that obesity and diabetes could act by decreasing the subjective improvement in functionality after surgery, and, in the case of obesity, also increase the risk of reoperation.

摘要

肥胖和糖尿病等代谢性疾病似乎会对慢性肩袖撕裂关节镜修复术后的再次手术及长期功能结局产生影响。这些病症在加那利群岛的患病率很高。开展了一项回顾性队列研究,纳入80例接受肩关节镜手术修复慢性肩袖撕裂的患者,进行至少5年的随访,以研究并发症、再次手术及功能结局的发生情况。糖尿病患者术后75%的功能得到改善,25%保持不变或恶化(比值比=1.444)。在非糖尿病患者组中,83.9%术后功能得到改善,16.1%保持不变或恶化(比值比=0.830)。肥胖患者术后76.6%的功能得到改善,23.4%保持不变或恶化(比值比=1.324)。在非肥胖组中,87.9%术后功能得到改善,12.1%保持不变或恶化(比值比=0.598)。尽管未获得统计学上的显著差异,但对所得结果的分析表明,肥胖和糖尿病可能通过降低术后功能的主观改善程度起作用,而就肥胖而言,还会增加再次手术的风险。

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