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肩袖修复术后 3 个月延迟:2 年随访。

Three-month Delay in Rotator Cuff Repair: 2-year Follow-up.

机构信息

From the Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT (Mr. Clinker, Dr. Ishikawa, Dr. Joyce, Dr. Tashjian, Dr. Chalmers); Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA (Dr. Smith).

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2024 Jan 22;8(1). doi: 10.5435/JAAOSGlobal-D-23-00283. eCollection 2024 Jan 1.

Abstract

INTRODUCTION

This study examined 2-year outcomes of patients who underwent delayed rotator cuff repair (RCR) compared with those who underwent RCR without delay.

METHODS

In this prospective comparative study, two groups were formed: (1) patients planning RCR during a 6-week elective surgery ban and (2) patients undergoing RCR at least 6 weeks after the ban. The Simple Shoulder Test, American Shoulder and Elbow Surgeon score, and visual analog scale for pain were collected preoperatively and at 2 years postoperatively. Magnetic resonance imaging assessed healing 6 months postoperatively.

RESULTS

With a 93.3% 2-year follow-up (13/15 delay group, 15/15 control), there was an 87-day difference in presentation to surgery (P = 0.001), with no significant preoperative demographic or tear characteristic differences between groups. Intraoperatively, there were no differences between groups in repair characteristics. Preoperative versus postoperative differences in American Shoulder and Elbow Surgeon score (P < 0.001), visual analog scale (P < 0.001), and Simple Shoulder Test scores (P < 0.001) were significant but not between groups (P = 0.650, 0.586, 0.525). On MRI, 58% in the delay group and 85% in the control group had healed (P = 0.202).

DISCUSSION

Although a 3-month delay showed no statistically significant effect on outcomes, the delay group had an approximately 27% higher failure rate. Thus, although a 3-month period of nonsurgical treatment before RCR may be reasonable, larger studies are warranted for definitive conclusions.

摘要

简介

本研究比较了延迟行肩袖修复术(RCR)与即刻行 RCR 的患者的 2 年转归。

方法

在这项前瞻性对比研究中,我们将患者分为两组:(1)计划在 6 周择期手术禁令期间行 RCR 的患者;(2)至少在禁令结束后 6 周行 RCR 的患者。在术前和术后 2 年收集简易肩部测试、美国肩肘外科医生评分和疼痛视觉模拟评分。术后 6 个月行 MRI 评估愈合情况。

结果

2 年随访率为 93.3%(延迟组 13/15,对照组 15/15),两组手术时间的差异为 87 天(P = 0.001),术前两组间在人口统计学和撕裂特征方面无显著差异。术中,两组的修复特征无差异。美国肩肘外科医生评分(P < 0.001)、视觉模拟评分(P < 0.001)和简易肩部测试评分(P < 0.001)在术前和术后均有显著差异,但组间无差异(P = 0.650,0.586,0.525)。MRI 显示,延迟组 58%、对照组 85%的患者愈合(P = 0.202)。

讨论

虽然 3 个月的延迟在统计学上对结果无显著影响,但延迟组的失败率约高 27%。因此,虽然在 RCR 前进行 3 个月的非手术治疗可能是合理的,但需要更大的研究来得出明确的结论。

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