PDF(Pubmed)
Abstract：
UNASSIGNED: To analyze the effect of stump-preserving repair on rotator cuff healing and shoulder function for degenerative total rotator cuff tears.
UNASSIGNED: A clinical data of 152 patients with degenerative total rotator cuff tears, who underwent arthroscopic repair between April 2019 and May 2022, was retrospectively analyzed. There were 76 males and 76 females with an average age of 55.4 years (range, 24-78 years). MRI was performed at 6 months postoperatively to evaluate the rotator cuff healing according to the Sugaya classification. Pre- and intra-operative related factors were included for univariate analysis, including age (≥60 years/<60 years), gender (male/female), passive activity disorder (yes/no), disease duration (≤3 months/>3 months), stump-preserving repair (yes/no), use of suture bridge technique (yes/no), shoulder joint abduction angle at knotting (<45°/≥45°), acromioplasty (yes/no), glucocorticoid injection (yes/no), time for patients to start postoperative passive exercise (≤2 weeks/>2 weeks), and time for patients to start postoperative active exercise (≤3 months/>3 months). The influencing factors of tendon healing were screened; further logistic regression was used to conduct multivariate analysis to screen for risk factors. Two sets of data were balanced by propensity score matching. The American Shoulder and Elbow Surgeons (ASES) score and Constant-Murley score of shoulder joint function at 6 and 12 months postoperatively, as well as rotator cuff healing rate at 6 months postoperatively, were compared between groups based on whether or not stump-preserving repair was used.
UNASSIGNED: All patients were followed up 12-33 months (mean, 23.8 months). MRI at 25-31 weeks postoperatively showed the 121 cases of rotator cuff healing and 31 cases of non healing. Univariate analysis showed that the disease duration, stump-preserving repair, shoulder joint abduction angle at knotting, and the time for patients to start postoperative active exercise were the influencing factors of rotator cuff healing ( P<0.05). Multivariate analysis showed that non-stump-preserving repair, shoulder abduction angle more than 45° at knotting, and the time to start active exercise within 3 months postoperatively were risk factors affecting rotator cuff healing ( P<0.05). A total of 51 pairs of cases were matched based on the grouping criteria of whether the disease duration exceeded 3 months, whether the shoulder abduction angle at knotting exceeded 45°, and whether the time to start postoperative active exercise exceeded 3 months. The rotator cuff healing rate, ASES score, and Constant-Murley score of the preserving repair group at 6 months postoperatively were superior to those of the non-preserving repair group, and the differences were significant ( P<0.05). There was no significant difference in ASES score and Constant-Murley score between the two groups at 12 months postoperatively ( P>0.05).
UNASSIGNED: For degenerative total rotator cuff tears, the stump-preserving repair can shorten the healing time and promote the shoulder function recovery, but has no significant effect on shoulder function at 1 year postoperatively.
UNASSIGNED: 探讨保留足印区残端的肩袖修补术对退行性肩袖全层撕裂术后肩袖愈合以及肩关节功能的影响。.
UNASSIGNED: 回顾性分析2019年4月—2022年5月152例接受关节镜下肩袖修补术的退行性肩袖全层撕裂患者临床资料。男76例，女76例；年龄24～78岁，平均55.4岁。术后6个月复查MRI，根据Sugaya分型评估肩袖愈合情况。对年龄（≥60岁/<60岁）、性别（男/女）、被动活动受限（是/否）、病程（≤3个月/>3个月）、保残修补（是/否）、缝线桥技术固定（是/否）、打结时肩关节外展角度（<45°/≥45°）、骨性肩峰成形（是/否）、治疗期间注射糖皮质激素（是/否）、术后开始被动锻炼时间（≤2周/>2周）、术后开始主动锻炼时间（≤3个月/>3个月）进行单因素分析，初步筛选肩袖愈合的影响因素；进一步采用logistic回归进行多因素分析，筛选危险因素。以是否使用保残修补作为分组条件，使用倾向性评分匹配平衡两组数据，对术后6、12个月肩关节功能美国肩肘外科协会评分（ASES）、Constant-Murley评分以及术后6个月肩袖愈合进行组间比较。.
UNASSIGNED: 术后152例患者均获随访，随访时间12～33个月，平均23.8个月。术后25～31周复查MRI示肩袖愈合121例、未愈合31例。单因素分析示病程、保残修补、打结时肩关节外展角度及术后开始主动锻炼时间是修补术后肩袖愈合的影响因素（ P<0.05）。多因素分析示术中不保残修补、打结时肩关节外展角度≥45° 及术后3个月内开始主动锻炼是影响肩袖愈合的危险因素（ P<0.05）。以是否保残修补为分组条件，以病程是否超过3个月、打结时肩外展角度是否超过45° 及术后开始主动锻炼时间是否超过3个月为筛选条件，共匹配51对患者。保残组术后6个月肩袖愈合率、ASES评分及Constant-Murley评分均优于非保残组，差异有统计学意义（ P<0.05）；两组术后12个月ASES评分及Constant-Murley评分差异无统计学意义（ P>0.05）。.
UNASSIGNED: 对于退行性全层肩袖撕裂患者，与不保留残端修补相比，保留足印区残端的肩袖修补术可以缩短肩袖愈合时间，肩关节功能恢复更快，但术后1年肩关节功能无明显差异。.
UNASSIGNED: A clinical data of 152 patients with degenerative total rotator cuff tears, who underwent arthroscopic repair between April 2019 and May 2022, was retrospectively analyzed. There were 76 males and 76 females with an average age of 55.4 years (range, 24-78 years). MRI was performed at 6 months postoperatively to evaluate the rotator cuff healing according to the Sugaya classification. Pre- and intra-operative related factors were included for univariate analysis, including age (≥60 years/<60 years), gender (male/female), passive activity disorder (yes/no), disease duration (≤3 months/>3 months), stump-preserving repair (yes/no), use of suture bridge technique (yes/no), shoulder joint abduction angle at knotting (<45°/≥45°), acromioplasty (yes/no), glucocorticoid injection (yes/no), time for patients to start postoperative passive exercise (≤2 weeks/>2 weeks), and time for patients to start postoperative active exercise (≤3 months/>3 months). The influencing factors of tendon healing were screened; further logistic regression was used to conduct multivariate analysis to screen for risk factors. Two sets of data were balanced by propensity score matching. The American Shoulder and Elbow Surgeons (ASES) score and Constant-Murley score of shoulder joint function at 6 and 12 months postoperatively, as well as rotator cuff healing rate at 6 months postoperatively, were compared between groups based on whether or not stump-preserving repair was used.
UNASSIGNED: All patients were followed up 12-33 months (mean, 23.8 months). MRI at 25-31 weeks postoperatively showed the 121 cases of rotator cuff healing and 31 cases of non healing. Univariate analysis showed that the disease duration, stump-preserving repair, shoulder joint abduction angle at knotting, and the time for patients to start postoperative active exercise were the influencing factors of rotator cuff healing ( P<0.05). Multivariate analysis showed that non-stump-preserving repair, shoulder abduction angle more than 45° at knotting, and the time to start active exercise within 3 months postoperatively were risk factors affecting rotator cuff healing ( P<0.05). A total of 51 pairs of cases were matched based on the grouping criteria of whether the disease duration exceeded 3 months, whether the shoulder abduction angle at knotting exceeded 45°, and whether the time to start postoperative active exercise exceeded 3 months. The rotator cuff healing rate, ASES score, and Constant-Murley score of the preserving repair group at 6 months postoperatively were superior to those of the non-preserving repair group, and the differences were significant ( P<0.05). There was no significant difference in ASES score and Constant-Murley score between the two groups at 12 months postoperatively ( P>0.05).
UNASSIGNED: For degenerative total rotator cuff tears, the stump-preserving repair can shorten the healing time and promote the shoulder function recovery, but has no significant effect on shoulder function at 1 year postoperatively.
UNASSIGNED: 探讨保留足印区残端的肩袖修补术对退行性肩袖全层撕裂术后肩袖愈合以及肩关节功能的影响。.
UNASSIGNED: 回顾性分析2019年4月—2022年5月152例接受关节镜下肩袖修补术的退行性肩袖全层撕裂患者临床资料。男76例，女76例；年龄24～78岁，平均55.4岁。术后6个月复查MRI，根据Sugaya分型评估肩袖愈合情况。对年龄（≥60岁/<60岁）、性别（男/女）、被动活动受限（是/否）、病程（≤3个月/>3个月）、保残修补（是/否）、缝线桥技术固定（是/否）、打结时肩关节外展角度（<45°/≥45°）、骨性肩峰成形（是/否）、治疗期间注射糖皮质激素（是/否）、术后开始被动锻炼时间（≤2周/>2周）、术后开始主动锻炼时间（≤3个月/>3个月）进行单因素分析，初步筛选肩袖愈合的影响因素；进一步采用logistic回归进行多因素分析，筛选危险因素。以是否使用保残修补作为分组条件，使用倾向性评分匹配平衡两组数据，对术后6、12个月肩关节功能美国肩肘外科协会评分（ASES）、Constant-Murley评分以及术后6个月肩袖愈合进行组间比较。.
UNASSIGNED: 术后152例患者均获随访，随访时间12～33个月，平均23.8个月。术后25～31周复查MRI示肩袖愈合121例、未愈合31例。单因素分析示病程、保残修补、打结时肩关节外展角度及术后开始主动锻炼时间是修补术后肩袖愈合的影响因素（ P<0.05）。多因素分析示术中不保残修补、打结时肩关节外展角度≥45° 及术后3个月内开始主动锻炼是影响肩袖愈合的危险因素（ P<0.05）。以是否保残修补为分组条件，以病程是否超过3个月、打结时肩外展角度是否超过45° 及术后开始主动锻炼时间是否超过3个月为筛选条件，共匹配51对患者。保残组术后6个月肩袖愈合率、ASES评分及Constant-Murley评分均优于非保残组，差异有统计学意义（ P<0.05）；两组术后12个月ASES评分及Constant-Murley评分差异无统计学意义（ P>0.05）。.
UNASSIGNED: 对于退行性全层肩袖撕裂患者，与不保留残端修补相比，保留足印区残端的肩袖修补术可以缩短肩袖愈合时间，肩关节功能恢复更快，但术后1年肩关节功能无明显差异。.
摘要：
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