Department of Orthopaedics and Traumatology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Department of Orthopaedics and Traumatology, Private Medline Adana Hospital, Adana, Turkey.
Turk J Med Sci. 2023 Feb;53(1):218-224. doi: 10.55730/1300-0144.5576. Epub 2023 Feb 22.
: Rotator cuff rupture (RCR) and glenohumeral osteoarthritis (GHO) are two common disorders of the shoulder joint. However, there are very few reports that examine the relationship between them. This study aimed to present at least two years' clinical results of arthroscopic rotator cuff repair of full-thickness and massive tears accompanied by arthroscopically detected early-stage osteoarthritis.
From August 2016 to December 2017, three hundred and twenty patients with total or massive rotator cuff tears were evaluated retrospectively. Thirty-five patients who were determined as stage 1 and 2 according to the Outerbridge scale for cartilage lesions were found appropriate for investigation. Patients were assessed using the University of California Los Angeles (UCLA) score, and a visual analog scale (VAS) score before surgery and at the final follow-up. The American Shoulder and Elbow Surgeons (ASES) shoulder score was used to evaluate the final outcomes and compare the UCLA shoulder scores.
The UCLA scores increased from the preoperative value of 19.1 ± 3.2 to 29.8 ± 4.8 at the last follow-up and increased by an average of 10.7 ± 6.0 (p < 0.001). The median VAS score decreased from the preoperative value of 3.0 to 1.0 (p < 0.001). Besides, the mean ASES score was found as 80.2 ± 10.6. An excellent positive correlation was found between postoperative UCLA scores and ASES scores (r = 0.887; p < 0.001).
To the best of our knowledge, this is one of the first arthroscopic comparative studies about the effect of early glenohumeral osteoarthritis on clinical outcomes after rotator cuff tear treatment. Finding good and excellent results up to 71% after RCR repair in patients with early-stage osteoarthritis was an indication that arthroscopic repair could be planned as the first-line treatment option for RCR pathologies in patients with early-stage degenerative arthritis without considering the rerupture rate.
肩袖撕裂（RCR）和肩峰下关节炎（GHO）是肩关节的两种常见疾病。然而，很少有研究检查它们之间的关系。本研究旨在介绍至少两年的关节镜下全层和巨大肩袖撕裂修复术的临床结果，这些肩袖撕裂伴有关节镜下发现的早期骨关节炎。
从 2016 年 8 月至 2017 年 12 月，对 320 例全层或巨大肩袖撕裂患者进行回顾性评估。根据软骨病变 Outerbridge 分级标准，发现 35 例分期为 1 期和 2 期的患者适合调查。患者术前和末次随访时采用加利福尼亚大学洛杉矶分校（UCLA）评分和视觉模拟评分（VAS）进行评估。采用美国肩肘外科医师协会（ASES）肩部评分评估最终结果，并比较 UCLA 肩部评分。
UCLA 评分从术前的 19.1±3.2 分提高到末次随访时的 29.8±4.8 分，平均提高 10.7±6.0 分（p<0.001）。VAS 评分中位数从术前的 3.0 分降至 1.0 分（p<0.001）。此外，平均 ASES 评分为 80.2±10.6。术后 UCLA 评分与 ASES 评分呈正相关（r=0.887；p<0.001）。
据我们所知，这是最早的关节镜对比研究之一，研究了早期肩峰下关节炎对肩袖撕裂治疗后临床结果的影响。在早期骨关节炎患者中，RCR 修复后获得良好和优秀结果的比例高达 71%，这表明关节镜修复可以作为早期退行性关节炎患者 RCR 病变的一线治疗选择，而不考虑再撕裂率。
