Miyake Satoshi, Shibata Terufumi, Kobayashi Shunsuke, Matsunaga Kei, Hata Naofumi, Shibata Yozo, Izaki Teruaki, Yamamoto Takuaki
Department of Orthopedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Department of Orthopedic Surgery, Fukuoka University, Chukushi Hospital, Fukuoka, Japan.
Orthop J Sports Med. 2024 Oct 9;12(10):23259671241276445. doi: 10.1177/23259671241276445. eCollection 2024 Oct.
Excessively high repair tension, especially tension ≥10 N, can lead to unsuccessful rotator cuff repair.
PURPOSE/HYPOTHESIS: The purpose of this study was to identify the preoperative risk factors for high repair tension in rotator cuff repair. It was hypothesized was that older age, longer symptom duration, nontraumatic (ie, degenerative) tear onset, progressive fatty degeneration, and larger tear size would be among the risk factors.
Cross-sectional study; Level of evidence, 3.
This retrospective study involved 80 patients (80 shoulders) diagnosed with rotator cuff tears by magnetic resonance imaging between July 2018 and August 2020. Repair tension was measured intraoperatively using a digital tension meter. Risk factors for high repair tension (≥10 N) were evaluated. The test was used to assess the relationship of repair tension with patient characteristics and surgical parameters. Parameters with a value of <.05 in the univariate analysis were entered into a multivariate logistic regression model to determine their relationship with repair tension ≥10 N.
Symptom duration of ≥4 months, nontraumatic tear onset, large/massive tears, mediolateral (ML) tear length of ≥20 mm, and anteroposterior (AP) tear length of ≥18 mm were associated with high odds of repair tension ≥10 N (≤ .013 for all). Multivariate analysis showed that nontraumatic onset, ML tear length of ≥20 mm, and AP tear length of ≥18 mm were independent risk factors for repair tension ≥10 N (≤ .035 for all).
The independent risk factors for high repair tension (≥10 N) during rotator cuff repair were nontraumatic tear onset, ML tear length of ≥20 mm, and AP tear length of ≥18 mm. Symptom duration of ≥4 months and large/massive tears were associated with high odds of repair tension ≥10 N, although they were not considered independent risk factors. Prospective cohort studies with larger sample sizes are needed to confirm the clinical value of the risk factors identified in this study.
过高的修复张力，尤其是张力≥10牛，可能导致肩袖修复失败。
目的/假设：本研究的目的是确定肩袖修复中高修复张力的术前危险因素。假设年龄较大、症状持续时间较长、非创伤性（即退行性）撕裂发作、进行性脂肪变性和撕裂尺寸较大是危险因素。
横断面研究；证据等级，3级。
这项回顾性研究纳入了2018年7月至2020年8月间通过磁共振成像诊断为肩袖撕裂的80例患者（80个肩部）。术中使用数字张力计测量修复张力。评估高修复张力（≥10牛）的危险因素。采用检验评估修复张力与患者特征和手术参数之间的关系。单因素分析中P值<0.05的参数被纳入多因素逻辑回归模型，以确定它们与修复张力≥10牛的关系。
症状持续时间≥4个月、非创伤性撕裂发作、大/巨大撕裂、中外侧（ML）撕裂长度≥20毫米和前后（AP）撕裂长度≥18毫米与修复张力≥10牛的高可能性相关（所有P值均≤0.013）。多因素分析显示，非创伤性发作、ML撕裂长度≥20毫米和AP撕裂长度≥18毫米是修复张力≥10牛的独立危险因素（所有P值均≤0.035）。
肩袖修复期间高修复张力（≥10牛）的独立危险因素是非创伤性撕裂发作、ML撕裂长度≥20毫米和AP撕裂长度≥18毫米。症状持续时间≥4个月和大/巨大撕裂与修复张力≥10牛的高可能性相关，尽管它们不被视为独立危险因素。需要更大样本量的前瞻性队列研究来证实本研究中确定的危险因素的临床价值。
