Kawamata Jun, Fukuta Shoji, Kano Masashi, Yoshikawa Kohei, Sairyo Koichi
Department of Orthopaedic Surgery, NHO Kochi National Hospital, Kochi, Japan.
Department of Orthopedics, Tokushima University, Tokushima, Japan.
JSES Int. 2025 Mar 17;9(4):1118-1123. doi: 10.1016/j.jseint.2025.02.011. eCollection 2025 Jul.
This study aimed to identify risk factors for retear after arthroscopic rotator cuff repair (ARCR) using the suture bridge method and to assess the relation between preoperative and postoperative tendon condition and retear.
We retrospectively analyzed patients who underwent ARCR for a medium tear. Potential risk factors, including tear width, anteroposterior and medial-lateral tear width, atrophy, fatty degeneration, and condition of the tendon stump (Ishitani's classification and rotator cuff/deltoid muscle [C/D] ratio), were identified on magnetic resonance preoperatively. Magnetic resonance imaging was performed regularly after surgery, and the C/D ratio in the sutured cuff was evaluated. Shoulders that were Sugaya type I-III were classified as the repair group and those that were type IV or V as the retear group. Risk factors for retear were analyzed by univariable and multivariable analyses.
We analyzed 175 patients in 183 shoulders. The overall retear rate was 13.1%. Multivariable analysis revealed medial-lateral width (odds ratio: 0.88; 95% confidence interval: 0.82-0.95; < .001) and C/D ratio (odds ratio: 0.30; 95% confidence interval: 0.16-0.58; < .001) as independent risk factors for retear. At 3 weeks postoperatively, the C/D ratio was significantly higher in the retear group (1.70 ± 1.47 vs. 0.84 ± 0.72; = .002).
The C/D ratio and tear width were risk factors for retear after ARCR using the suture bridge method. The C/D ratio was higher in retear cases both preoperatively and postoperatively.
本研究旨在确定采用缝线桥接方法进行关节镜下肩袖修复（ARCR）后再撕裂的危险因素，并评估术前和术后肌腱状况与再撕裂之间的关系。
我们回顾性分析了因中度撕裂接受ARCR的患者。术前通过磁共振成像确定潜在的危险因素，包括撕裂宽度、前后和内外侧撕裂宽度、萎缩、脂肪变性以及肌腱残端状况（石谷分类和肩袖/三角肌[C/D]比值）。术后定期进行磁共振成像，并评估缝合肩袖的C/D比值。Sugaya I-III型的肩部归为修复组，IV或V型的肩部归为再撕裂组。通过单变量和多变量分析来分析再撕裂的危险因素。
我们分析了183例肩部的175例患者。总体再撕裂率为13.1%。多变量分析显示，内外侧宽度（比值比：0.88；95%置信区间：0.82-0.95；P<0.001）和C/D比值（比值比：0.30；95%置信区间：0.16-0.58；P<0.001）是再撕裂的独立危险因素。术后3周，再撕裂组的C/D比值显著更高（1.70±1.47 vs. 0.84±0.72；P=0.002）。
C/D比值和撕裂宽度是采用缝线桥接方法进行ARCR后再撕裂的危险因素。再撕裂病例术前和术后的C/D比值均较高。
