术前长期使用非甾体类抗炎药对肩袖、跟腱、肱二头肌远端或股四头肌腱修复术后的翻修率无影响。
Long-Term Preoperative Nonsteroidal Anti-inflammatory Drug Use Does Not Impact Revision Rate After Repair of Rotator Cuff, Achilles, Distal Biceps, or Quadriceps Tendon.
作者信息
Parmar Romir, Tummala Sailesh V, Holle Alejandro, Iturregui Jose, Hoffer Alexander J, Tokish John M
机构信息
The University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, U.S.A.
Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A.
出版信息
Arthrosc Sports Med Rehabil. 2024 Oct 26;7(2):101034. doi: 10.1016/j.asmr.2024.101034. eCollection 2025 Apr.
PURPOSE
To determine whether long-term preoperative nonsteroidal anti-inflammatory drug (NSAID) use affected the revision rates after primary tendon repair for the following common sports medicine surgical procedures: rotator cuff repair (RCR), Achilles tendon repair (ATR), distal biceps repair (DBR), or quadriceps tendon repair (QTR).
METHODS
A retrospective comparative study using a national insurance database was performed. Patients who underwent major tendon repair, including RCR, ATR, DBR, or QTR, with at least 2-year follow-up were identified. Those who had a diagnosis of long-term NSAID use prior to the index operation were identified and matched 1:4 to controls without NSAID use based on age, sex, specific tendon repaired, and Elixhauser Comorbidity Index. The revision repair rates of the 2 groups were compared.
RESULTS
A total of 36,068 patients underwent major tendon repair. Of these, 7,246 (20%) met the long-term NSAID use criteria prior to tendon repair (NSAID users). After RCR, 3.2% of NSAID users (n = 190) and 2.6% of controls (n = 617) underwent revision surgery within 2 years (odds ratio [OR], 1.15; 95% confidence interval [CI], 0.97-1.36; = .10). After ATR, NSAID users had a revision rate of 3.9% (n = 24) versus 2.5% (n = 62) in the control cohort (OR, 1.47; 95% CI, 0.89-2.38; = .12). After DBR, both NSAID users and controls had fewer than 11 revision cases (OR, 1.54; 95% CI, 0.49-4.16; = .42). After QTR, the revision rate was 5.9% (n = 30) for NSAID users compared with 4.8% (n = 95) for the control group (OR, 1.22; 95% CI, 0.77-1.86; = .38). None of the observed differences in revision rates between NSAID users and controls were significant.
CONCLUSIONS
Patients with a diagnosis of and coding for long-term preoperative NSAID use do not have greater revision rates within 2 years of primary tendon repair than patients without this diagnosis.
LEVEL OF EVIDENCE
Level III, retrospective case-control study.
目的
确定长期术前使用非甾体抗炎药（NSAID）是否会影响以下常见运动医学手术的初次肌腱修复术后的翻修率：肩袖修复术（RCR）、跟腱修复术（ATR）、肱二头肌远端修复术（DBR）或股四头肌肌腱修复术（QTR）。
方法
利用国家保险数据库进行一项回顾性比较研究。确定接受主要肌腱修复（包括RCR、ATR、DBR或QTR）且至少随访2年的患者。确定那些在初次手术前被诊断为长期使用NSAID的患者，并根据年龄、性别、修复的特定肌腱和埃利克斯豪泽合并症指数按1:4与未使用NSAID的对照组进行匹配。比较两组的翻修修复率。
结果
共有36068例患者接受了主要肌腱修复。其中，7246例（20%）在肌腱修复前符合长期使用NSAID的标准（NSAID使用者）。在RCR术后，2年内3.2%的NSAID使用者（n = 190）和2.6%的对照组患者（n = 617）接受了翻修手术（优势比[OR]，1.15；95%置信区间[CI]，0.97 - 1.36；P = 0.10）。在ATR术后，NSAID使用者的翻修率为3.9%（n = 24），而对照组为2.5%（n = 62）（OR，1.47；95% CI，0.89 - 2.38；P = 0.12）。在DBR术后，NSAID使用者和对照组的翻修病例均少于11例（OR，1.54；95% CI，0.49 - 4.16；P = 0.42）。在QTR术后，NSAID使用者的翻修率为5.9%（n = 30），而对照组为4.8%（n = 95）（OR，1.22；95% CI，0.77 - 1.86；P = 0.38）。NSAID使用者和对照组之间观察到的翻修率差异均无统计学意义。
结论
术前诊断并编码为长期使用NSAID的患者在初次肌腱修复术后2年内的翻修率并不高于未作此诊断的患者。
证据水平
III级，回顾性病例对照研究。
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