Department of Trauma & Orthopaedics, West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, UK.
Int Orthop. 2024 May;48(5):1271-1275. doi: 10.1007/s00264-024-06127-2. Epub 2024 Feb 26.
The optimal timing of surgery after traumatic rotator cuff tears (RCT) is unclear, with its impact on functional outcomes under debate. This study aimed to review functional outcomes after RCT repair in patients who underwent early vs delayed surgery at our unit.
This was single-centre retrospective evaluation. Patients with an acute traumatic RCT that underwent repair between 2017 and 2019 and had local follow-up were included and placed into two groups: early surgery (within 6 months from injury) and delayed surgery (more than 6 months from injury). Patient demographics, RCT data and pre- and post-operative (after 12 months) Oxford Shoulder Score (OSS) were extracted from medical records. Data was analysed to compare OSS scores between groups, as well as the effect of cuff tear sizes on OSS scores.
Forty-nine patients were included in the analysis (15 early, 34 delayed). There were no significant differences in age, sex or cuff tear sizes between groups. No difference was identified in the mean post-operative OSS between early vs delayed groups (40.9 ± 6.34 vs 40.5 ± 7.65, p = 0.86). The mean improvement in OSS after surgery was also similar between groups (22.5 ± 7.81 vs 20.97 ± 7.19, p = 0.498). Having a large or massive RCT did not worsen OSS compared to small or medium RCT (p = 0.44), even when stratified by early or delayed surgery.
Delayed surgery for traumatic RCT greater than 6 months from injury did not negatively impact long-term functional outcomes at our unit. Patients should be reassured as applicable before surgery in the event of prolonged or unavoidable delays.
创伤性肩袖撕裂（RCT）后手术的最佳时机尚不清楚，其对功能结果的影响存在争议。本研究旨在回顾我们科室接受早期与延迟手术的 RCT 修复患者的功能结果。
这是一项单中心回顾性评估。纳入 2017 年至 2019 年期间因急性创伤性 RCT 而接受修复并在当地接受随访的患者，并将其分为两组：早期手术（伤后 6 个月内）和延迟手术（伤后 6 个月以上）。从病历中提取患者人口统计学、RCT 数据以及术前和术后（12 个月后）牛津肩评分（OSS）。对数据进行分析，以比较两组之间的 OSS 评分，以及肩袖撕裂大小对 OSS 评分的影响。
分析中纳入 49 例患者（早期 15 例，延迟 34 例）。两组间年龄、性别或肩袖撕裂大小无显著差异。早期与延迟组间术后平均 OSS 无差异（40.9±6.34 与 40.5±7.65，p=0.86）。两组间术后 OSS 平均改善程度也相似（22.5±7.81 与 20.97±7.19，p=0.498）。与小或中 RCT 相比，大或巨大 RCT 并不会使 OSS 恶化（p=0.44），即使在早期或延迟手术分层时也是如此。
在我们科室，伤后大于 6 个月的创伤性 RCT 行延迟手术并不会对长期功能结果产生负面影响。在手术前，应根据具体情况让患者放心，以避免或延长手术时间。
