Assunção Jorge H, Da Silva Pedro T, Gracitelli Mauro E, Checchia Caio, Malavolta Eduardo A
Orthopaedics and Traumatology, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA.
Orthopaedics, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA.
Cureus. 2024 Oct 16;16(10):e71589. doi: 10.7759/cureus.71589. eCollection 2024 Oct.
Rotator cuff syndrome is a common cause of medical appointments and surgeries. The aim of this study is to compare the clinical outcomes of patients with work-related problems who underwent arthroscopic repair of full-thickness rotator cuff tears (RCTs) versus those without work-related or social security claims.
A retrospective cohort study comparing the outcomes of American Shoulder and Elbow Surgeons (ASES) and University of California at Los Angeles Shoulder Rating (UCLA) scores 24 months after arthroscopic repair of full-thickness RCTs of patients with and without work-related problems was performed. Patients with work-related problems were defined as those who received financial assistance from their employer or social security for more than 16 weeks before or after surgery, or those who were unable to return to work or had to change or re-adapt their job function.
We evaluated 419 shoulders (411 patients), 102 shoulders with work-related claims and 317 shoulders without these claims. ASES and UCLA scores from both groups improved significantly (p < 0.001) 24 months after surgery. Patients with work-related problems had comparatively lower preoperative ASES and UCLA scores (p = 0.047 and p = 0.021, respectively) and obtained lower values after intervention for both scores, achieving 71.9 ± 18.8 on the ASES score and 28.1 ± 5.6 on the UCLA score at 24 months post-operatively. Meanwhile, patients without work-related complaints scored 82.1 ± 19 points on the ASES score and 30.1 ± 5.6 points on the UCLA score at 24 months post-operatively (p = 0.007 and p = 0.045, respectively).
At two-year follow-up, patients with work-related claims have significant improvement after arthroscopic repair of full-thickness RCTs by the ASES and UCLA scores. However, they have worse clinical outcomes than patients without these claims.
肩袖综合征是就医和手术的常见原因。本研究的目的是比较接受全层肩袖撕裂（RCT）关节镜修复的有工作相关问题的患者与无工作相关或社会保障索赔的患者的临床结局。
进行一项回顾性队列研究，比较有和无工作相关问题的患者在全层RCT关节镜修复术后24个月时的美国肩肘外科医师学会（ASES）评分和加州大学洛杉矶分校肩峰评分（UCLA）。有工作相关问题的患者定义为在手术前或手术后从雇主或社会保障获得超过16周经济援助的患者，或无法重返工作岗位或必须改变或重新适应工作职能的患者。
我们评估了419个肩部（411名患者），其中102个肩部有工作相关索赔，317个肩部无此类索赔。两组患者术后24个月时ASES和UCLA评分均显著改善（p<0.001）。有工作相关问题的患者术前ASES和UCLA评分相对较低（分别为p = 0.047和p = 0.021），干预后这两个评分的值也较低，术后24个月时ASES评分为71.9±18.8，UCLA评分为28.1±5.6分。同时，无工作相关主诉的患者术后24个月时ASES评分为82.1±19分，UCLA评分为30.1±5.6分（分别为p = 0.007和p = 0.045）
在两年随访中，有工作相关索赔的患者在全层RCT关节镜修复术后通过ASES和UCLA评分有显著改善。然而与无此类索赔的患者相比，他们的临床结局更差。
