关节镜修复术后合并症在肩袖再撕裂中的作用：TriNetX数据库对98844例患者的回顾分析
The role of medical comorbidities in rotator cuff retear after arthroscopic repair: a TriNetX database review of 98,844 patients.
作者信息
Mahmoud Yusuf, Ramtin Sina, Quindlen Caroline E, Chung Juliet, Kellish Alec S, Ilyas Asif M, Davis Daniel E
机构信息
Department of Orthopaedic Surgery, Hackensack Meridian School of Medicine, Clifton, NJ, USA.
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA, USA.
出版信息
JSES Int. 2025 Jan 6;9(3):678-682. doi: 10.1016/j.jseint.2024.11.024. eCollection 2025 May.
BACKGROUND
Arthroscopic rotator cuff repair (ARCR) is the most common form of operative intervention utilized in the treatment of rotator cuff tears. Retear rates following ARCR have been reported to range from 7% to 94%. This study was undertaken to better understand the effects of various medical comorbidities and age on rotator cuff retear risk following ARCR.
METHODS
The TriNetX US Collaborative Network was queried for all patients treated with ARCR from 2013 to 2022 with recurrence of rotator cuff tear within 1 year. Cohorts were defined by inclusion of medical comorbidities at time of ARCR including hypertension, hyperlipidemia, chronic ischemic heart disease, type 2 diabetes mellitus, smoking history, and chronic kidney disease. Patient age groups in 10-year increments were also examined. Propensity score matching was performed for comorbid groups to adjust for age and comorbidities. Relative risk was calculated for each comorbidity and age group.
RESULTS
There were a total of 98,844 patients who underwent ARCR for complete rotator cuff tear from 2012 to 2023 with an overall retear percentage of 16.3% within 1 year of surgery. Hypertension, hyperlipidemia, and smoking history were significant risk factors of retear after propensity score matching. Chronic ischemic heart disease, chronic kidney disease, and type 2 diabetes mellitus were not significant risk factors of retear after propensity score matching. It was also noted that relative risk of retear increased as patient age increased; patients aged 81-90 having the highest likelihood of retear (relative risk: 1.206), with a retear rate of 19.6%.
CONCLUSION
Medical comorbidities and advanced age can increase the risk of rotator cuff retear following ARCR. Understanding how these common comorbidities affect retear rate following ARCR can better inform orthopedic surgeons of potential risks and optimize postoperative outcomes.
背景
关节镜下肩袖修复术（ARCR）是治疗肩袖撕裂最常用的手术干预方式。据报道，ARCR术后再撕裂率在7%至94%之间。本研究旨在更好地了解各种内科合并症和年龄对ARCR术后肩袖再撕裂风险的影响。
方法
查询TriNetX美国协作网络中2013年至2022年接受ARCR治疗且在1年内出现肩袖撕裂复发的所有患者。队列根据ARCR时存在的内科合并症定义，包括高血压、高脂血症、慢性缺血性心脏病、2型糖尿病、吸烟史和慢性肾脏病。还检查了以10岁为增量的患者年龄组。对合并症组进行倾向评分匹配，以调整年龄和合并症。计算每个合并症和年龄组的相对风险。
结果
2012年至2023年共有98,844例患者因肩袖完全撕裂接受ARCR，术后1年内总体再撕裂率为16.3%。倾向评分匹配后，高血压、高脂血症和吸烟史是再撕裂的显著危险因素。倾向评分匹配后，慢性缺血性心脏病、慢性肾脏病和2型糖尿病不是再撕裂的显著危险因素。还注意到，再撕裂的相对风险随着患者年龄的增加而增加；81-90岁的患者再撕裂可能性最高（相对风险：1.206），再撕裂率为19.6%。
结论
内科合并症和高龄会增加ARCR术后肩袖再撕裂的风险。了解这些常见合并症如何影响ARCR术后的再撕裂率，可以更好地告知骨科医生潜在风险并优化术后结果。
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