Fares Austin B, Scanaliato John P, Green Clare K, Dunn John C, Gordon Michael, Parnes Nata
Orthopedics. 2023 Jul-Aug;46(4):242-249. doi: 10.3928/01477447-20230125-07. Epub 2023 Jan 30.
This study sought to investigate the influence of a preexisting overweight condition (body mass index [BMI], 25-29.9 kg/m) on functional outcomes after arthroscopic rotator cuff repair surgery. A retrospective review was performed examining the outcomes of arthroscopic rotator cuff repair in a normal-weight (BMI, 18.5-24.9 kg/m) and an overweight (BMI, 25-29.9 kg/m) population. Functional outcomes were assessed to include the American Shoulder and Elbow Surgeons (ASES) score, the Single Assessment Numeric Evaluation score, and the visual analog scale (VAS) pain score, as well as range of motion in forward flexion, external rotation, and internal rotation. A total of 52 normal-weight patients (mean BMI, 23.7±2.1 kg/m) and 57 overweight patients (mean BMI, 28.4±1.4 kg/m) were included. Both groups demonstrated statistically and clinically significant improvements in VAS score, Single Assessment Numeric Evaluation score, and ASES score at final follow-up (<.0001), with no difference in range of motion (>.05). Overall, when comparing outcomes between the groups, there were significantly better outcomes in the normal-weight group's VAS scores (mean, 0.56±0.96 vs 1.3±1.7; =.0064), ASES scores (mean, 96.1±5.8 vs 92.4±9.7; =.0187), and internal rotation (mean thoracic vertebrae, 9.2±3.0 vs 10.4±2.6; =.0289). However, these differences did not reach clinical significance regarding the threshold of patients meeting standard minimal clinically important difference, substantial clinical benefit, and patient-acceptable symptomatic state for rotator cuff repairs. Over-weight patients have improved outcomes after arthroscopic rotator cuff repair surgery with noninferior clinical results when compared with normal-weight patients. More data regarding outcomes of overweight patients will help physicians make better-informed decisions when considering rotator cuff repair. [. 2023;46(4):242-249.].
本研究旨在调查术前超重状态(体重指数[BMI],25 - 29.9kg/m²)对关节镜下肩袖修补术后功能结局的影响。进行了一项回顾性研究,检查正常体重(BMI,18.5 - 24.9kg/m²)和超重(BMI,25 - 29.9kg/m²)人群关节镜下肩袖修补的结局。评估的功能结局包括美国肩肘外科医师(ASES)评分、单评估数字评价评分和视觉模拟量表(VAS)疼痛评分,以及前屈、外旋和内旋的活动范围。共纳入52例正常体重患者(平均BMI,23.7±2.1kg/m²)和57例超重患者(平均BMI,28.4±1.4kg/m²)。两组在末次随访时VAS评分、单评估数字评价评分和ASES评分均有统计学和临床意义的改善(P <.0001),活动范围无差异(P >.05)。总体而言,比较两组结局时,正常体重组的VAS评分(均值,0.56±0.96 vs 1.3±1.7;P =.0064)、ASES评分(均值,96.1±5.8 vs 92.4±9.7;P =.0187)和内旋(平均胸椎,9.2±3.0 vs 10.4±2.6;P =.0289)明显更好。然而,就达到肩袖修补标准最小临床重要差异、显著临床获益和患者可接受症状状态的患者阈值而言,这些差异未达到临床意义。与正常体重患者相比,超重患者关节镜下肩袖修补术后结局有所改善,临床结果不差。更多关于超重患者结局的数据将有助于医生在考虑肩袖修补时做出更明智的决策。[《……》. 2023;46(4):242 - 249.]