Camacho-Sanchez Maria Rosario, Calzado-Alvarez Irene, Minarro Jose Carlos, Dussan-Arango Diana Maria, López-Medina Clementina, Izquierdo-Fernandez Alberto
Orthopedic Surgery and Traumatology Department, Alto Guadalquivir Hospital, 23740 Jaen, Spain.
Faculty of Medicine, University of Córdoba, 14004 Córdoba, Spain.
Life (Basel). 2025 Aug 7;15(8):1254. doi: 10.3390/life15081254.
(1) Background and aim: The benefit of surgical treatment compared to conservative management is unclear in degenerative cuff tears, and there is limited evidence regarding midterm functional outcomes. This study sought to compare the midterm functional outcomes of surgical versus conservative treatment for rotator cuff tears. (2) Methods: All patients on the waiting list for arthroscopy of cuff tears in a single center between 2013 and 2015 were analyzed. They were divided into two groups: those who underwent surgery (arthroscopy group) and those who declined the procedure (orthopedic group). The primary endpoint was shoulder functionality, evaluated with the CMS, SST, and SPADI-SP questionnaires. Inverse probability of treatment weighting (IPTW) was used to account for differences between the groups. (3) Results: Of 57 patients (67 (62-71) years old, 47% women), 32 were in the arthroscopy group and 25 in the orthopedic group. Functionality was assessed at a median of 7 (7-8) years after diagnosis. The patients in the arthroscopy group were younger ( = 0.023) and more frequently women ( = 0.074). No significant differences were observed in the type of tear ( = 0.205) or laterality ( = 0.164). Functional outcome analysis showed more favorable scores in the surgical group: constant (74.5 ± 16.6 vs. 58.4 ± 23, = 0.016), SST (7.3 ± 3.1 vs. 4.9 ± 4.2, = 0.016), and SPADI-SP (35.7 ± 26.6 vs. 56.1 ± 30.4, = 0.006). (4) Conclusions: In this cohort of patients with cuff tears, arthroscopic repair was associated with better clinical and functional midterm results compared to conservative treatment, although the benefit was less evident in older patients and those with complete tears.
(1) 背景与目的：在退行性肩袖撕裂中，手术治疗与保守治疗相比的益处尚不清楚，且关于中期功能结局的证据有限。本研究旨在比较肩袖撕裂手术治疗与保守治疗的中期功能结局。(2) 方法：对2013年至2015年期间在单一中心等待肩袖撕裂关节镜检查的所有患者进行分析。他们被分为两组：接受手术的患者（关节镜组）和拒绝手术的患者（骨科组）。主要终点是肩部功能，采用CMS、SST和SPADI-SP问卷进行评估。使用治疗权重的逆概率（IPTW）来考虑两组之间的差异。(3) 结果：57例患者（年龄67（62 - 71）岁，47%为女性），其中32例在关节镜组，25例在骨科组。在诊断后中位7（7 - 8）年时评估功能。关节镜组患者更年轻（P = 0.023）且女性比例更高（P = 0.074）。在撕裂类型（P = 0.205）或患侧（P = 0.164）方面未观察到显著差异。功能结局分析显示手术组得分更优：Constant评分（74.5 ± 16.6对58.4 ± 23，P = 0.016）、SST评分（7.3 ± 3.1对4.9 ± 4.2，P = 0.016）和SPADI-SP评分（35.7 ± 26.6对56.1 ± 30.4，P = 0.006）。(4) 结论：在这组肩袖撕裂患者中，与保守治疗相比，关节镜修复术在中期临床和功能方面的结果更好，尽管在老年患者和完全撕裂患者中益处不太明显。
