Li ZengXin, Wang ZengYan, Sun Bo, Wang DengFeng, Guo JianPing, Pan Hua
Department of Orthopedic Surgery II, Affiliated Hospital of Beihua University, Jilin, Jilin, China.
Department of Spinal Surgery, Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, China.
J Clin Lab Anal. 2025 Jul;39(13):e70043. doi: 10.1002/jcla.70043. Epub 2025 Jun 12.
This study was to investigate the correlation between plasma nerve growth factor (NGF) and postoperative range of motion (ROM) in patients with rotator cuff tears (RCT).
From January 2022 to March 2024, a total of 135 patients with degenerative RCT were included. The patients were divided into Stiff group (n = 42) and Non-Stiff group (n = 93) accordingly. The receiver operating characteristic curve (ROC) and area under the curve (AUC) were drawn to evaluate the predictive value of plasma NGF for postoperative joint stiffness. The Spearman test was used to analyze the relationship between plasma NGF and joint motion, VAS score, and joint function scores (UCLA score and Constant score). The relationship between plasma NGF and postoperative ROM and risk of joint stiffness was evaluated by restricted cubic spline (RCS) analysis of independent variables.
In the preoperative and postoperative comparison, the two groups improved in joint flexion, VAS pain score, and joint function, except that the external rotation of the Stiff group did not change before and after surgery. After surgery, the ROM of the Stiff group was still significantly limited, and the ROM and joint function scores were lower than those of the Non-Stiff group (p < 0.01).
This study suggests that reduced plasma NGF in patients with degenerative RCT may be associated with early shoulder stiffness, showing a negative non-linear dose-response relationship. On a clinical basis, plasma NGF is beneficial to quantify the risk of early shoulder stiffness after RCT.
本研究旨在探讨肩袖撕裂（RCT）患者血浆神经生长因子（NGF）与术后活动范围（ROM）之间的相关性。
纳入2022年1月至2024年3月共135例退行性RCT患者。将患者相应分为僵硬组（n = 42）和非僵硬组（n = 93）。绘制受试者工作特征曲线（ROC）和曲线下面积（AUC），以评估血浆NGF对术后关节僵硬的预测价值。采用Spearman检验分析血浆NGF与关节活动度、视觉模拟评分（VAS）以及关节功能评分（加州大学洛杉矶分校（UCLA）评分和Constant评分）之间的关系。通过自变量的限制立方样条（RCS）分析评估血浆NGF与术后ROM及关节僵硬风险之间的关系。
术前与术后比较，两组在关节屈曲、VAS疼痛评分和关节功能方面均有改善，只是僵硬组的外旋在手术前后未发生变化。术后，僵硬组的ROM仍明显受限，ROM和关节功能评分低于非僵硬组（p < 0.01）。
本研究表明，退行性RCT患者血浆NGF降低可能与早期肩部僵硬有关，呈现负性非线性剂量反应关系。在临床上，血浆NGF有助于量化RCT后早期肩部僵硬的风险。
