Parmar Romir, Tummala Sailesh V, Holle Alejandro, Iturregui Jose, Hoffer Alexander J, Tokish John M
The University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, U.S.A.
Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, Arizona, U.S.A.
Arthrosc Sports Med Rehabil. 2024 Oct 26;7(2):101034. doi: 10.1016/j.asmr.2024.101034. eCollection 2025 Apr.
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).
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.
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.
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 III, retrospective case-control study.
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）。
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。
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。
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。
III级，回顾性病例对照研究。
