Takatori Naoki, Uchiyama Yoshiyasu, Imai Takeshi, Wasai Shiho, Watanabe Masahiko
Department of Orthopaedic Surgery, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan.
Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
JSES Int. 2025 Apr 15;9(4):1183-1190. doi: 10.1016/j.jseint.2025.03.016. eCollection 2025 Jul.
Various intrinsic and extrinsic factors have been reported for rotator cuff tears (RCTs). This study aimed to assess the relationship between preoperative body composition parameters and postoperative clinical score in patients who underwent surgery for RCT.
The participants in this study were 42 patients (42 shoulders; 33 men, 9 women) who underwent preoperative measurement of body composition and were then evaluated 1 year after surgical rotator cuff repair. Mean age at the time of examination was 61 years. Clinical outcomes were quantified using the Constant-Murley score, then patients were divided into an excellent group (Group E; Constant-Murley score ≥80) and a failure group (Group F; Constant-Murley score ≤79). Patient's background characteristics, preoperative physical findings, and body composition parameters were compared between Groups E and F.
Appendicular skeletal muscle mass (SMM) index of the upper limb on the affected side and phase angle were significantly higher in Group E (appendicular SMM index: Group E 0.50 ± 0.11 kg/m, Group F 0.42 ± 0.12 kg/m, = .027; phase angle: Group E 5.41° ± 0.62°, Group F 4.98° ± 0.51°, = .032) and showed significant positive correlations with the clinical score (appendicular SMM index: = .002, r = 0.474; phase angle: = .001, r = 0.490). Conversely, the ratio of extracellular water to total body water was significantly higher in Group F (Group E 42.95% ± 2.58%, Group F 44.69% ± 3.02%; = .031) and showed a significant negative correlation with the clinical score ( = .005, r = -0.426).
A relationship between RCT and whole-body condition has been reported but no reports have clarified the relationships between body composition parameters and clinical score for patients with RCTs. Relationships between preoperative body composition parameters and postoperative clinical score were investigated in patients with RCTs. The group with better preoperative body composition parameters showed significantly better postoperative clinical score. Moreover, the postoperative clinical score correlated positively with the appendicular SMM index and phase angle and negatively with extracellular water/total body water. These findings suggest that measuring body composition preoperatively may provide predictors of postoperative clinical score in patients with RCTs.
已有多种内在和外在因素被报道与肩袖撕裂（RCT）相关。本研究旨在评估接受RCT手术患者的术前身体成分参数与术后临床评分之间的关系。
本研究的参与者为42例患者（42个肩部；33例男性，9例女性），他们在术前进行了身体成分测量，随后在肩袖修复手术后1年接受评估。检查时的平均年龄为61岁。使用Constant-Murley评分对临床结果进行量化，然后将患者分为优组（E组；Constant-Murley评分≥80）和失败组（F组；Constant-Murley评分≤79）。比较E组和F组患者的背景特征、术前体格检查结果和身体成分参数。
E组患侧上肢的附属骨骼肌质量（SMM）指数和相位角显著更高（附属SMM指数：E组0.50±0.11kg/m，F组0.42±0.12kg/m，P = 0.027；相位角：E组5.41°±0.62°，F组4.98°±0.51°，P = 0.032），并且与临床评分呈显著正相关（附属SMM指数：P = 0.002，r = 0.474；相位角：P = 0.001，r = 0.490）。相反，F组细胞外水与全身水的比例显著更高（E组42.95%±2.58%，F组44.69%±3.02%；P = 0.031），并且与临床评分呈显著负相关（P = 0.005，r = -0.426）。
已有报道称RCT与全身状况之间存在关联，但尚无报道阐明RCT患者身体成分参数与临床评分之间的关系。本研究调查了RCT患者术前身体成分参数与术后临床评分之间的关系。术前身体成分参数较好的组术后临床评分显著更好。此外，术后临床评分与附属SMM指数和相位角呈正相关，与细胞外水/全身水呈负相关。这些发现表明，术前测量身体成分可能为RCT患者术后临床评分提供预测指标。
