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对于初次创伤性前下肩关节脱位后因肩袖撕裂接受单纯肩袖修复的40岁及以上患者,可获得优异的功能结果。

Excellent functional outcomes in patients aged 40 years or older undergoing isolated rotator cuff repair for rotator cuff tears after primary traumatic anteroinferior shoulder dislocation.

作者信息

Hochberger Felix, Rupp Marco-Christopher, Boenke Felix, Scheiderer Bastian, Siebenlist Sebastian, Muench Lukas N, Berthold Daniel P

机构信息

Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig- Ludwig-Haus, Brettreichstrasse 11, 97074, Wuerzburg, Germany.

出版信息

Arch Orthop Trauma Surg. 2025 Apr 9;145(1):233. doi: 10.1007/s00402-025-05785-0.

Abstract

PURPOSE

To investigate the functional outcomes of patients over 40 years of age who underwent isolated rotator cuff (RC) repair (RCR) for full-thickness RC tears resulting from a primary traumatic anteroinferior shoulder dislocation and to compare these outcomes with a control group of patients who underwent RCR for instability-independent RC tears, with a minimum follow-up of two years.

MATERIALS AND METHODS

Patients aged 40 years and older were included for RCR following primary traumatic anteroinferior shoulder dislocation between 01/2012 and 06/2020 with a minimum follow-up of two years. Patients were excluded if they received an additional labral repair or capsular shift. Outcomes were compared to a control group of patients who underwent RCR without history of previous dislocations. Primary outcome measures included passive range of motion (ROM) as well as patient reported outcomes comprising the Western Ontario Shoulder Instability Index (WOSI) and Rowe score. Rates of re-dislocation were evaluated as secondary outcomes.

RESULTS

Thirty-six patients were enrolled and divided into 2 groups (n = 18, respectively). Demographic characteristics did not significantly differ (p > 0.05). At final follow-up, patients affected by instability-related RC tears showed comparable functional outcomes in terms of WOSI (427.2 ± 238.9 vs. 431.1 ± 252.1; p = 0.962) and Rowe (87.5 ± 12.0 vs. 91.1 ± 10.2; p = 0.339) scores as well as in terms of passive ROM (abduction: 88.1 ± 4.6° vs. 86.7 ± 11.5°; p = 0.637, forward elevation: 87.8 ± 6.2° vs. 88.3 ± 5.1°; p = 0.772, external rotation: 55.3 ± 10.5° vs. 50.8 ± 15.3°; p = 0.312, internal rotation: 65.3 ± 8.5 vs. 68.8 ± 4.9, p = 0.388). No patient experienced a re-dislocation.

CONCLUSION

Patients ≥ 40 years who underwent isolated RCR without labral repair or capsular shift for a concurrent RC tear after experiencing a primary traumatic anteroinferior shoulder dislocation, achieved favorable functional outcomes along with absence of re-dislocations.

STUDY DESIGN

Retrospective case series; Level of Evidence IV.

摘要

目的

研究40岁以上因原发性创伤性肩关节前下脱位导致全层肩袖(RC)撕裂而接受单纯肩袖修复(RCR)的患者的功能结局,并将这些结局与一组因与不稳定无关的RC撕裂而接受RCR的对照组患者进行比较,随访时间至少为两年。

材料与方法

纳入2012年1月至2020年6月间因原发性创伤性肩关节前下脱位接受RCR且随访时间至少为两年的40岁及以上患者。如果患者接受了额外的盂唇修复或关节囊移位,则将其排除。将结局与一组既往无脱位病史且接受RCR的对照组患者进行比较。主要结局指标包括被动活动范围(ROM)以及患者报告的结局,包括西安大略肩关节不稳定指数(WOSI)和Rowe评分。再脱位率作为次要结局进行评估。

结果

共纳入36例患者,分为2组(每组n = 18)。人口统计学特征无显著差异(p > 0.05)。在末次随访时,受不稳定相关RC撕裂影响的患者在WOSI(427.2±238.9 vs. 431.1±252.1;p = 0.962)和Rowe评分(87.5±12.0 vs. 91.1±10.2;p = 0.339)以及被动ROM方面(外展:88.1±4.6° vs. 86.7±11.5°;p = 0.637,前屈:87.8±6.2° vs. 88.3±5.1°;p = 0.772,外旋:55.3±10.5° vs. 50.8±15.3°;p = 0.312,内旋:65.3±8.5 vs. 68.8±4.9,p = 0.388)显示出相当的功能结局。没有患者发生再脱位。

结论

40岁及以上患者在经历原发性创伤性肩关节前下脱位后因并发RC撕裂接受单纯RCR且未进行盂唇修复或关节囊移位,获得了良好的功能结局且无再脱位发生。

研究设计

回顾性病例系列;证据级别IV。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b476/11982164/5af6ae86792d/402_2025_5785_Fig1_HTML.jpg

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