Chi Hannah M, Davies Michael R, Vijittrakarnrung Chaiyanun, Motamedi Daria, Ma C Benjamin, Feeley Brian T, Lansdown Drew A
School of Medicine, University of California San Francisco, San Francisco, California, USA.
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.
Orthop J Sports Med. 2024 Jul 31;12(7):23259671241257825. doi: 10.1177/23259671241257825. eCollection 2024 Jul.
The impact of early glenohumeral osteoarthritis (GHOA) on clinical outcomes after rotator cuff repair (RCR) remains unclear. The magnetic resonance imaging (MRI)-based Shoulder Osteoarthritis Severity (SOAS) score is a comprehensive approach to quantifying glenohumeral degeneration.
To investigate the association between SOAS scores and changes in American Shoulder and Elbow Surgeons (ASES) scores in patients who underwent RCR.
Cohort study; Level of evidence, 3.
Two reviewers independently analyzed the preoperative MRI scans of 116 shoulders and assigned SOAS scores. Spearman correlation was used to calculate the association of mean SOAS scores with patient demographic characteristics and change in ASES scores over the 2-year follow-up period (ΔASES). Multivariate regression analysis was performed between the independent variables of patient age, sex, body mass index, and significant SOAS score components as determined by univariate analysis, with the dependent variable being ΔASES. Significance was defined as < .05 for univariate analysis and < .0125 after application of the Bonferroni correction for multivariate analysis.
The mean ASES scores were 55.8 ± 18.6 preoperatively and 92.1 ± 12.1 at 2 years postoperatively. The mean preoperative SOAS score was 15.2 ± 7.1. On univariate analysis, the total SOAS score was positively correlated with patient age ( = 0.41; < .001), whereas ΔASES was negatively correlated with patient age ( = -0.27; = .0032). Increasing SOAS subscores for supraspinatus/infraspinatus tear size ( = -0.28; = .024), tendon retraction ( = -0.23; = .015), muscle atrophy ( = -0.20; = .034), paralabral ganglia ( = -0.23; = .015), and cartilage degeneration ( = -0.21; = .024) were negatively correlated with ΔASES. A negative correlation was found between increasing total SOAS score and ΔASES ( = -0.22; = .016). On multivariate analysis, increasing supraspinatus/infraspinatus tear size was significantly and negatively correlated with ΔASES (β = -3.3; = .010).
Increasing the total SOAS score was predictive of less improvement in ASES scores at 2 years postoperatively. On univariate analysis, SOAS subscores with the strongest negative correlations with ΔASES scores included tear size, muscle atrophy, tendon retraction, paralabral ganglia, and cartilage wear. On multivariate analysis, only tear size was significantly associated with a lower change in the ASES score.
早期盂肱关节骨关节炎（GHOA）对肩袖修复术（RCR）后临床疗效的影响尚不清楚。基于磁共振成像（MRI）的肩关节骨关节炎严重程度（SOAS）评分是一种量化盂肱关节退变的综合方法。
探讨接受RCR患者的SOAS评分与美国肩肘外科医师（ASES）评分变化之间的关联。
队列研究；证据等级，3级。
两名研究者独立分析116例肩部术前MRI扫描结果并给出SOAS评分。采用Spearman相关性分析计算平均SOAS评分与患者人口统计学特征以及2年随访期内ASES评分变化（ΔASES）之间的关联。对患者年龄、性别、体重指数等自变量以及单因素分析确定的显著SOAS评分成分进行多因素回归分析，因变量为ΔASES。单因素分析的显著性定义为P<0.05，多因素分析应用Bonferroni校正后显著性定义为P<0.0125。
术前平均ASES评分为55.8±18.6，术后2年为92.1±12.1。术前平均SOAS评分为15.2±7.1。单因素分析显示，SOAS总分与患者年龄呈正相关（r=0.41；P<0.001），而ΔASES与患者年龄呈负相关（r=-0.27；P=0.0032）。肩峰下/冈下肌撕裂大小（r=-0.28；P=0.024）、肌腱回缩（r=-0.23；P=0.015）、肌肉萎缩（r=-0.20；P=0.034）、盂唇旁神经节（r=-0.23；P=0.015）和软骨退变（r=-0.21；P=0.024）的SOAS子评分增加与ΔASES呈负相关。SOAS总分增加与ΔASES呈负相关（r=-0.22；P=0.016）。多因素分析显示，肩峰下/冈下肌撕裂大小增加与ΔASES显著负相关（β=-3.3；P=0.010）。
SOAS总分增加预示术后2年ASES评分改善较少。单因素分析中，与ΔASES评分负相关性最强的SOAS子评分包括撕裂大小、肌肉萎缩、肌腱回缩、盂唇旁神经节和软骨磨损。多因素分析中，只有撕裂大小与ASES评分较低变化显著相关。
