Lee Jung Sub, Suh Kuen Tak, Shin Won Chul, Bae Jung Yun, Goh Tae Sik, Jung Sung Won, Choi Min-Hyeok, Kang Suk-Woong
Department of Orthopedics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea.
Department of Orthopedics, Sehung Hospital, Busan 47250, Republic of Korea.
Medicina (Kaunas). 2024 Apr 17;60(4):640. doi: 10.3390/medicina60040640.
Few studies have investigated the socioeconomic factors associated with retear after rotator cuff repair. This study aimed to identify the risk factors, including socioeconomic factors, for rotator cuff retear in patients who underwent arthroscopic rotator cuff repair. This retrospective study included 723 patients diagnosed with full-thickness rotator cuff tears who underwent arthroscopic rotator cuff repair from March 2010 to March 2021. The outcome variable was rotator cuff retear observed on postoperative magnetic resonance imaging or ultrasonography. Sex, age, obesity, diabetes, symptom duration, and tear size were the independent variables. Socioeconomic variables included occupation, educational level, type of medical insurance, and area of residence. We compared patients with and without retear and estimated the effects of the independent factors on retear risk. The mean age of the patients, symptom duration, and tear size were 62.4 ± 8.0 years, 1.8 ± 1.7 years, and 21.8 ± 12.5 mm, respectively. The age, type of medical insurance, diabetes, tear size, and symptom duration differed significantly between patients with and without retearing ( < 0.05). Age, occupation, type of medical insurance, diabetes, initial tear size, and symptom duration significantly affected the risk of retear. Patients who performed manual labor had a significantly higher retear rate ( = 0.005; OR, 1.95; 95% CI, 1.23-3.11). The highest retear risk was seen in patients with Medicaid insurance ( < 0.001; OR, 4.34; 95% CI, 2.09-9.02). Age, initial tear size, and symptom duration significantly affect retear risk after arthroscopic rotator cuff repair. Occupation and type of medical insurance were also risk factors for retear. Socioeconomically vulnerable patients may be at a greater risk of retear. Proactive efforts are required to expand early access to medical care.
很少有研究调查与肩袖修复术后再撕裂相关的社会经济因素。本研究旨在确定接受关节镜下肩袖修复术患者肩袖再撕裂的危险因素，包括社会经济因素。这项回顾性研究纳入了2010年3月至2021年3月期间接受关节镜下肩袖修复术的723例被诊断为全层肩袖撕裂的患者。结局变量是术后磁共振成像或超声检查发现的肩袖再撕裂。性别、年龄、肥胖、糖尿病、症状持续时间和撕裂大小为自变量。社会经济变量包括职业、教育水平、医疗保险类型和居住地区。我们比较了有再撕裂和无再撕裂的患者，并评估了独立因素对再撕裂风险的影响。患者的平均年龄、症状持续时间和撕裂大小分别为62.4±8.0岁、1.8±1.7年和21.8±12.5毫米。有再撕裂和无再撕裂的患者在年龄、医疗保险类型、糖尿病、撕裂大小和症状持续时间方面存在显著差异（<0.05）。年龄、职业、医疗保险类型、糖尿病、初始撕裂大小和症状持续时间显著影响再撕裂风险。从事体力劳动的患者再撕裂率显著更高（=0.005；OR，1.95；95%CI，1.23-3.11）。医疗补助保险患者的再撕裂风险最高（<0.001；OR，4.34；95%CI，2.09-9.02）。年龄、初始撕裂大小和症状持续时间显著影响关节镜下肩袖修复术后的再撕裂风险。职业和医疗保险类型也是再撕裂的危险因素。社会经济弱势患者可能有更高的再撕裂风险。需要积极努力扩大早期医疗服务的可及性。
