Hayek Christyon, Lam Patrick H, Hawa Ala' Fayeq Mohamed, Bilbrough James P, Murrell George A C
Orthopaedic Research Institute, Kogarah, Sydney, Australia.
Univeristy of New South Wales, Randwick, Sydney, New South Wales, Australia.
Orthop J Sports Med. 2025 Jul 18;13(7):23259671251355125. doi: 10.1177/23259671251355125. eCollection 2025 Jul.
Few studies have assessed the impact of trauma history and preoperative symptom duration on cuff integrity after arthroscopic rotator cuff repair (RCR).
To assess the hypothesis that acute, traumatic rotator cuff tears are less likely to retear after arthroscopic RCR compared with chronic, atraumatic tears.
Cohort study; Level of evidence, 3.
We conducted a post hoc analysis of prospectively collected data for 2335 consecutive patients who underwent primary arthroscopic RCR and were evaluated for retear on ultrasound 6 months postoperatively. A single-row knotless repair technique was used for all patients. The cohort was divided into patients who recalled a specific event that instigated their symptoms ("traumatic" group) and those who did not ("atraumatic" group). Chi-square test was utilized to assess the difference in retear rate between the traumatic and atraumatic groups. Multivariate logistic regression analyses were performed to identify independent predictors of retear, and receiver operating characteristic curve analysis was used to evaluate the accuracy of the regression equations.
The traumatic and atraumatic groups consisted of 1489 and 846 patients, respectively. There was no significant difference in retear rate between the traumatic and atraumatic groups (13% and 11%, respectively; = .14). In the entire cohort, trauma history and preoperative symptom duration were not predictive of retear. In the traumatic group, larger tear size area was the strongest independent predictor of retear (area under the curve [AUC], 0.76; 99% CI, 0.70-81), followed by longer operative time (AUC, 0.69; 99% CI, 0.64-0.74), older patient age (AUC, 0.68; 99% CI, 0.63-0.73) and full-thickness tear (AUC, 0.66; 99% CI, 0.61-0.71). In the atraumatic group, larger tear size area was the strongest independent predictor (AUC, 0.76; 99% CI, 0.68-0.83), followed by older patient age (AUC, 0.67; 99% CI, 0.59-0.75) and full-thickness tear (AUC, 0.66; 99% CI, 0.58-0.73).
Trauma history and preoperative symptom duration did not affect cuff integrity 6 months after arthroscopic RCR. More important factors associated with enhanced repair integrity included smaller tear size and younger patient age.
很少有研究评估创伤史和术前症状持续时间对关节镜下肩袖修复术（RCR）后肩袖完整性的影响。
评估与慢性非创伤性撕裂相比，急性创伤性肩袖撕裂在关节镜下RCR术后再撕裂可能性较小的假设。
队列研究；证据等级，3级。
我们对2335例连续接受初次关节镜下RCR手术并在术后6个月接受超声检查评估再撕裂情况的患者的前瞻性收集数据进行了事后分析。所有患者均采用单排无结修复技术。该队列分为回忆起引发其症状的特定事件的患者（“创伤性”组）和未回忆起的患者（“非创伤性”组）。采用卡方检验评估创伤性组和非创伤性组之间再撕裂率的差异。进行多因素逻辑回归分析以确定再撕裂的独立预测因素，并使用受试者工作特征曲线分析来评估回归方程的准确性。
创伤性组和非创伤性组分别由1489例和846例患者组成。创伤性组和非创伤性组之间的再撕裂率无显著差异（分别为13%和11%；P = 0.14）。在整个队列中，创伤史和术前症状持续时间不能预测再撕裂。在创伤性组中，较大的撕裂面积是再撕裂最强的独立预测因素（曲线下面积[AUC]，0.76；99%可信区间，0.70 - 0.81），其次是较长的手术时间（AUC，0.69；99%可信区间，0.64 - 0.74）、患者年龄较大（AUC，0.68；99%可信区间，0.63 - 0.73）和全层撕裂（AUC，0.66；99%可信区间，0.61 - 0.71）。在非创伤性组中，较大的撕裂面积是最强的独立预测因素（AUC，0.76；99%可信区间，0.68 - 0.83），其次是患者年龄较大（AUC，0.67；99%可信区间，0.59 - 0.75）和全层撕裂（AUC，0.66；99%可信区间，0.58 - 0.73）。
创伤史和术前症状持续时间不影响关节镜下RCR术后6个月时的肩袖完整性。与修复完整性增强相关的更重要因素包括较小的撕裂面积和较年轻的患者年龄。
