Department of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Orthop Traumatol. 2023 May 11;24(1):21. doi: 10.1186/s10195-023-00706-6.
Although fibromyalgia is associated with poor outcomes following orthopedic surgeries, several studies show some benefit from surgical intervention and nevertheless recommend operative treatment when indicated. There is sparse evidence of the effect of fibromyalgia on the outcomes of shoulder surgery. The purpose of this study was to investigate the effect of fibromyalgia on patient-reported outcomes of arthroscopic rotator cuff repair (ARCR).
All patients with a confirmed diagnosis of fibromyalgia who underwent ARCR in one institution between 2010 and 2021 were included. Data retrieved from medical records included demographics, characteristics of the cuff tear and the surgical procedure, and preoperative and last follow-up (minimum 1 year) postoperative Disabilities of the Arm, Shoulder and Hand (DASH) score, Subjective Shoulder score (SSV), and Numeric Pain Rating Scale (NPRS). A matched controlled group of patients without fibromyalgia who had undergone ARCR was selected according to age, sex, and preoperative DASH, SSV, and NPRS scores.
There were no significant differences in demographics, cuff tear and surgical procedure characteristics, and preoperative scores between the fibromyalgia and control groups. The fibromyalgia patients' postoperative scores for all 3 measurements showed significant improvement: SSV by 32.1 (P = 0.004), DASH by 20.3 (P = 0.016), and NPRS by 2.33 (P = 0.017). There were no significant differences in the postoperative DASH, SSV, and NPRS between the fibromyalgia and control groups.
Fibromyalgia patients with rotator cuff tears who undergo ARCR do not have inferior patient-reported outcomes compared with non-fibromyalgia controls. Fibromyalgia should not be a considered a contraindication for ARCR.
III.
尽管纤维肌痛与骨科手术后的不良结局相关,但多项研究表明手术干预有一定益处,因此仍建议在适应证下进行手术治疗。纤维肌痛对肩部手术结局的影响证据有限。本研究旨在探讨纤维肌痛对关节镜下肩袖修复术(ARCR)患者报告结局的影响。
本研究纳入了 2010 年至 2021 年期间在一家机构接受 ARCR 治疗且确诊为纤维肌痛的所有患者。从病历中提取的数据包括人口统计学资料、肩袖撕裂和手术过程的特征,以及术前和最后一次随访(至少 1 年)时的术后手臂、肩部和手功能障碍(DASH)评分、主观肩部评分(SSV)和数字疼痛评分量表(NPRS)。根据年龄、性别以及术前 DASH、SSV 和 NPRS 评分,选择了一组无纤维肌痛且接受 ARCR 的匹配对照组患者。
纤维肌痛组和对照组在人口统计学资料、肩袖撕裂和手术过程特征以及术前评分方面均无显著差异。纤维肌痛患者的所有 3 项测量结果的术后评分均显著改善:SSV 改善 32.1(P=0.004),DASH 改善 20.3(P=0.016),NPRS 改善 2.33(P=0.017)。纤维肌痛组和对照组的术后 DASH、SSV 和 NPRS 评分无显著差异。
接受 ARCR 治疗的肩袖撕裂伴纤维肌痛患者的患者报告结局并不逊于非纤维肌痛对照组。纤维肌痛不应成为 ARCR 的禁忌证。
III 级。