Department of Orthopaedic Surgery, Lu'an Hospital of Traditional Chinese Medicine Affiliated of Anhui University of Traditional Chinese Medicine, Lu'an, 237000, Anhui, China.
Department of Oncology, Lu'an Hospital of Traditional Chinese Medicine Affiliated of Anhui, University of Traditional Chinese Medicine, Lu'an, 237000, Anhui, China.
BMC Musculoskelet Disord. 2024 Oct 8;25(1):795. doi: 10.1186/s12891-024-07897-x.
The impact of the etiology of rotator cuff injury (RCI) on outcomes after rotator cuff repair remains unclear. This study aimed to evaluate the postoperative outcomes of patients with RCIs of different etiologies and identify the risk factors affecting prognosis.
This study included 73 patients with RCI who underwent arthroscopic rotator cuff repair. The patients were categorized into either a traumatic group or a non-traumatic group based on their history of trauma. Preoperative and postoperative assessments included shoulder range of motion, muscle strength, and physical examination findings specific to the shoulder for both groups. Clinical differences between arthroscopic repair of traumatic and non-traumatic RCIs were evaluated using univariate analysis. Logistic regression analysis determined independent risk factors for rotator cuff repair prognosis.
Among the 73 patients, 31 were in the traumatic group and 42 in the non-traumatic group, with a minimum postoperative follow-up of 12 months and a mean follow-up of 13.8 months. The duration of the disease was significantly longer in the non-traumatic group compared with the traumatic group (P < 0.001). The mean tear area was more significant in the traumatic group than in the non-traumatic group (P = 0.003), and the preoperative pain level and functional scores were better in the non-traumatic group compared with the traumatic group. Postoperatively, there were no differences between the two groups regarding scores, joint mobility, strength, and complications. At 12 months postoperatively, multivariate regression analysis indicated that full-layer tear (OR = 5.106, 95% CI: 1.137-22.927, P = 0.033), fat infiltration (OR = 6.020, 95% CI: 1.113-32.554, P = 0.037), and tear area (OR = 6.038, 95% CI: 2.122-17.177, P < 0.001) significantly affected the University of California at Los Angeles (UCLA) score.
Compared with non-traumatic RCI, traumatic RCI presents with more pronounced pain and impaired joint function preoperatively yet demonstrates comparable postoperative clinical outcomes. Full-layer tears, fat infiltration, and large tear areas are unfavorable factors affecting rotator cuff repair, and postoperative rehabilitation management of these patients should be emphasized.
肩袖损伤（RCI）病因对肩袖修复术后结果的影响尚不清楚。本研究旨在评估不同病因 RCI 患者术后结果，并确定影响预后的危险因素。
本研究纳入 73 例接受关节镜下肩袖修复的 RCI 患者。根据外伤史，将患者分为创伤组和非创伤组。两组均进行术前和术后的肩关节活动范围、肌肉力量和肩关节体格检查。采用单因素分析评估创伤性和非创伤性 RCI 关节镜修复的临床差异。采用 logistic 回归分析确定肩袖修复预后的独立危险因素。
73 例患者中，创伤组 31 例，非创伤组 42 例，术后随访时间至少 12 个月，平均随访 13.8 个月。非创伤组疾病持续时间明显长于创伤组（P<0.001）。创伤组的平均撕裂面积大于非创伤组（P=0.003），非创伤组术前疼痛程度和功能评分优于创伤组。术后两组在评分、关节活动度、肌力和并发症方面无差异。术后 12 个月，多变量回归分析显示全层撕裂（OR=5.106，95%CI：1.137-22.927，P=0.033）、脂肪浸润（OR=6.020，95%CI：1.113-32.554，P=0.037）和撕裂面积（OR=6.038，95%CI：2.122-17.177，P<0.001）显著影响加利福尼亚大学洛杉矶分校（UCLA）评分。
与非创伤性 RCI 相比，创伤性 RCI 术前疼痛更明显，关节功能受损，但术后临床结果相当。全层撕裂、脂肪浸润和较大撕裂面积是影响肩袖修复的不利因素，应加强对这些患者的术后康复管理。
