Cederqvist Sanna, Flinkkilä Tapio, Tuominen Antti, Sormaala Markus, Ylinen Jari, Kautiainen Hannu, Sirniö Kai, Pamilo Konsta, Kiviranta Ilkka, Paloneva Juha
Department of Musculoskeletal Diseases, Tampere University Hospital, Tampere, Finland.
Department of Surgery, Division of Orthopaedic and Trauma Surgery, Oulu University Hospital, Oulu, Finland.
Bone Jt Open. 2024 Sep 20;5(9):793-799. doi: 10.1302/2633-1462.59.BJO-2024-0092.R1.
Rotator cuff disease (RCD) can considerably decrease quality of life. Here, we investigated whether health-related quality of life (HRQoL) influences the need for surgery in patients with RCD.
We performed an analysis of 417 patients with symptomatic RCD who were recruited from two hospitals between June 2008 and December 2014 to be randomized to receive non-surgical or surgical treatment. After a three-month rehabilitation period, 36-Item Short-Form Health Survey questionnaire (SF-36), shoulder pain (visual analogue scale (VAS)), and shoulder function (Constant-Murley score) data were available from 191 still-symptomatic patients who were eligible for surgery. A control group was formed from 87 excluded patients who were no longer eligible for surgery due to relief of symptoms.
Mean pain on the VAS was 51.3 (SD 20.1) in the patients eligible for surgery and 41.7 (SD 21.2) in the control group. The following domains of the SF-36 were associated with being eligible for surgery in univariate analyses: bodily pain, general health, vitality, social functioning, and emotional wellbeing. In multivariate analysis, only bodily pain was associated with pursuing surgical treatment. The RCD population's values for physical role, bodily pain, and physical functioning were poorer compared to the values of the general population.
Lower HRQoL, as indicated by the lower bodily pain score on the SF-36, was associated with the decision to undergo surgical treatment in patients with RCD. Therefore, HRQoL should be considered when determining treatment options for RCD.
肩袖疾病（RCD）会显著降低生活质量。在此，我们调查了与健康相关的生活质量（HRQoL）是否会影响RCD患者的手术需求。
我们对2008年6月至2014年12月期间从两家医院招募的417例有症状的RCD患者进行了分析，这些患者被随机分配接受非手术或手术治疗。经过三个月的康复期后，从191例仍有症状且符合手术条件的患者中获得了36项简短健康调查问卷（SF-36）、肩部疼痛（视觉模拟量表（VAS））和肩部功能（Constant-Murley评分）的数据。对照组由87例因症状缓解而不再符合手术条件的排除患者组成。
符合手术条件的患者VAS平均疼痛评分为51.3（标准差20.1），对照组为41.7（标准差21.2）。在单因素分析中，SF-36的以下领域与符合手术条件相关：身体疼痛、总体健康、活力、社会功能和情绪健康。在多因素分析中，只有身体疼痛与寻求手术治疗相关。与普通人群相比，RCD人群在身体角色、身体疼痛和身体功能方面的得分较低。
SF-36中较低的身体疼痛评分表明较低的HRQoL与RCD患者接受手术治疗的决定相关。因此，在确定RCD的治疗方案时应考虑HRQoL。
