Department of Orthopaedic Surgery, Lu'an Hospital of Traditional Chinese Medicine Affiliated of Anhui University of Traditional Chinese Medicine, Lu'an, Anhui, 237000, China.
Department of Rehabilitation, Lu'an Hospital of Traditional Chinese Medicine Affiliated of Anhui University of Traditional Chinese Medicine, Lu'an, Anhui, 237000, China.
J Orthop Surg Res. 2024 Jun 21;19(1):368. doi: 10.1186/s13018-024-04858-x.
The effects of the timing of surgical repair on the outcomes of traumatic and non-traumatic rotator cuff injuries (RCI) remain elusive. Thus, this study aimed to compare differences in outcomes following the repair of traumatic and non-traumatic RCI at varying time points.
The study population comprised 87 patients with traumatic and non-traumatic RCI who underwent arthroscopic rotator cuff repair and were followed up for a minimum of 6 months. Next, the trauma and the non-trauma groups were stratified into subgroups according to the time of injury (early repair: occurring within 3 months; delayed repair: occurring after 3 months). Measurements before and after surgical interventions were compared to evaluate the effect of the duration of RCI on the functional status of patients in the trauma and non-trauma groups. Primary evaluation indices included the Visual Analog Scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder function score, and the University of California, Los Angeles (UCLA) shoulder score. Secondary evaluation indices consisted of shoulder range of motion (ROM), postoperative rotator cuff retear rate, and incidence of joint stiffness.
Among the 40 patients in the trauma group, 22 underwent early repair, whereas the remaining 18 underwent delayed repair. In the non-trauma group consisting of 47 patients, 18 underwent early repair, whereas the remaining 29 underwent delayed repair. The minimum clinical follow-up time was 6 months, with an average follow-up time of 10.2 months. During postoperative follow-up, 1 and 6 patients who underwent early and delayed repair experienced re-tear in the trauma group, respectively. Contrastingly, 3 and 8 patients who underwent early and delayed repair presented with re-tear in the non-trauma group, respectively.
Early repair of traumatic RCI yielded superior outcomes, including improved range of motion, lower pain symptoms, and lower risk of postoperative re-tears compared to delayed repair. Additionally, non-surgical treatment is recommended as the preferred approach for patients with non-traumatic RCI.
手术修复时机对创伤性和非创伤性肩袖损伤(RCI)结局的影响仍难以捉摸。因此,本研究旨在比较不同时间点行创伤性和非创伤性 RCI 修复后的结果差异。
研究人群包括 87 例接受关节镜下肩袖修复的创伤性和非创伤性 RCI 患者,随访时间至少 6 个月。然后,根据损伤时间(早期修复:发生在 3 个月内;延迟修复:发生在 3 个月后)将创伤组和非创伤组分为亚组。比较手术干预前后的测量值,以评估 RCI 持续时间对创伤组和非创伤组患者功能状态的影响。主要评估指标包括视觉模拟评分(VAS)疼痛评分、美国肩肘外科医师(ASES)评分、Constant 肩部功能评分和加利福尼亚大学洛杉矶分校(UCLA)肩部评分。次要评估指标包括肩部活动范围(ROM)、术后肩袖再撕裂率和关节僵硬发生率。
在 40 例创伤组患者中,22 例患者行早期修复,其余 18 例患者行延迟修复。在由 47 例患者组成的非创伤组中,18 例患者行早期修复,其余 29 例患者行延迟修复。最短临床随访时间为 6 个月,平均随访时间为 10.2 个月。在术后随访期间,分别有 1 例和 6 例行早期和延迟修复的患者出现撕裂再发。相比之下,分别有 3 例和 8 例行早期和延迟修复的患者出现撕裂再发。
与延迟修复相比,早期修复创伤性 RCI 可获得更好的结果,包括改善活动范围、降低疼痛症状和降低术后再撕裂风险。此外,对于非创伤性 RCI 患者,建议首选非手术治疗。