Abstract：
OBJECTIVE: This study aimed to investigate the correlation between rotator cuff stump classification and postoperative outcomes after superior capsular reconstruction (SCR).
METHODS: A total of 75 patients who underwent SCR between June 2013 and May 2021 were included in this study. Based on stump classification using the signal intensity ratio of the tendon rupture site to the deltoid muscle in the coronal view of preoperative T2-weighted, fat-suppressed magnetic resonance imaging scans, the patients were classified into types 1, 2, and 3 with ratios of <0.8, 0.8-1.3, and >1.3 (44, 17, and 14 patients, respectively). The American Shoulder and Elbow Surgeons (ASES), Constant, and visual analog scale (VAS) scores for pain and range of motion were evaluated at a minimum of 1 year of follow-up postoperatively. The acromiohumeral distance and rotator cuff arthropathy according to the Hamada classification were assessed on plain radiography. The graft integrity was evaluated by magnetic resonance imaging at 3 and 12 months postoperatively and annually thereafter.
RESULTS: Clinical and radiological outcomes were significantly improved after SCR. In comparison with type 2 and 3 patients, type 1 patients had significantly higher ASES scores (type 1, 2, and 3 = 84 ± 10, 75 ± 15, and 76 ± 14; all P = .014), Constant scores (type 1, 2, and 3 = 65 ± 5, 61 ± 9, and 56 ± 13; all P = .005), and forward flexion (type 1, 2, and 3 = 155 ± 10, 154 ± 15, and 145 ± 13; all P = .013). However, these statistical differences between groups were below the established minimum clinically important difference values for the ASES and Constant scores after rotator cuff repair. The graft failure rate after surgery was lower in the type 1 group than that in the other 2 groups; however, the difference was not statistically significant (P = .749).
CONCLUSIONS: Patients with stump classification type 1 showed significantly better functional scores (ASES and VAS scores) and forward flexion; however, the clinical importance of these differences may be limited. Stump classification may be useful for predicting postoperative clinical outcomes.
METHODS: A total of 75 patients who underwent SCR between June 2013 and May 2021 were included in this study. Based on stump classification using the signal intensity ratio of the tendon rupture site to the deltoid muscle in the coronal view of preoperative T2-weighted, fat-suppressed magnetic resonance imaging scans, the patients were classified into types 1, 2, and 3 with ratios of <0.8, 0.8-1.3, and >1.3 (44, 17, and 14 patients, respectively). The American Shoulder and Elbow Surgeons (ASES), Constant, and visual analog scale (VAS) scores for pain and range of motion were evaluated at a minimum of 1 year of follow-up postoperatively. The acromiohumeral distance and rotator cuff arthropathy according to the Hamada classification were assessed on plain radiography. The graft integrity was evaluated by magnetic resonance imaging at 3 and 12 months postoperatively and annually thereafter.
RESULTS: Clinical and radiological outcomes were significantly improved after SCR. In comparison with type 2 and 3 patients, type 1 patients had significantly higher ASES scores (type 1, 2, and 3 = 84 ± 10, 75 ± 15, and 76 ± 14; all P = .014), Constant scores (type 1, 2, and 3 = 65 ± 5, 61 ± 9, and 56 ± 13; all P = .005), and forward flexion (type 1, 2, and 3 = 155 ± 10, 154 ± 15, and 145 ± 13; all P = .013). However, these statistical differences between groups were below the established minimum clinically important difference values for the ASES and Constant scores after rotator cuff repair. The graft failure rate after surgery was lower in the type 1 group than that in the other 2 groups; however, the difference was not statistically significant (P = .749).
CONCLUSIONS: Patients with stump classification type 1 showed significantly better functional scores (ASES and VAS scores) and forward flexion; however, the clinical importance of these differences may be limited. Stump classification may be useful for predicting postoperative clinical outcomes.
摘要：
目的：探讨肩袖残端分类与上囊重建（SCR）术后预后的相关性。
方法：本研究纳入了2013年6月至2021年5月期间接受SCR的75例患者。基于残端分类，在术前T2加权的冠状视图中使用肌腱断裂部位与三角肌的信号强度比，脂肪抑制MRI扫描,患者分为1型、2型和3型，比例分别为<0.8、0.8-1.3和>1.3（44、17和14例患者，分别)。美国肩肘外科医生（ASES），常数,术后至少1年随访,评估疼痛和活动范围的视觉模拟量表(VAS)评分.在X线平片上评估了根据Hamada分类的肩关节距离和RC撕裂性关节病。在术后3个月和12个月以及之后每年通过MRI评估术后移植物的完整性。移植物失败定义为完全不连续。
结果：SCR术后临床和放射学结果明显改善。与2型和3型患者相比，1型患者的ASES评分明显较高（1、2和3型=84±10、75±15和76±14；所有P=0.014），恒定分数（类型1、2和3=65±5、61±9和56±13；所有P=0.005），和向前屈曲（类型1、2和3=155±10、154±15和145±13；所有P=0.013）。然而,组间的这些统计学差异低于肩袖修复后ASES和Constant评分确定的最低临床重要差异值.1型组术后移植物失败率低于其他两组;差异无统计学意义(P=0.749)。
结论：残端分类类型1的患者表现出明显更好的功能评分（ASES和VAS评分）和前向屈曲；然而，这些差异的临床重要性可能有限.残端分类可用于预测术后临床结果。
方法：本研究纳入了2013年6月至2021年5月期间接受SCR的75例患者。基于残端分类，在术前T2加权的冠状视图中使用肌腱断裂部位与三角肌的信号强度比，脂肪抑制MRI扫描,患者分为1型、2型和3型，比例分别为<0.8、0.8-1.3和>1.3（44、17和14例患者，分别)。美国肩肘外科医生（ASES），常数,术后至少1年随访,评估疼痛和活动范围的视觉模拟量表(VAS)评分.在X线平片上评估了根据Hamada分类的肩关节距离和RC撕裂性关节病。在术后3个月和12个月以及之后每年通过MRI评估术后移植物的完整性。移植物失败定义为完全不连续。
结果：SCR术后临床和放射学结果明显改善。与2型和3型患者相比，1型患者的ASES评分明显较高（1、2和3型=84±10、75±15和76±14；所有P=0.014），恒定分数（类型1、2和3=65±5、61±9和56±13；所有P=0.005），和向前屈曲（类型1、2和3=155±10、154±15和145±13；所有P=0.013）。然而,组间的这些统计学差异低于肩袖修复后ASES和Constant评分确定的最低临床重要差异值.1型组术后移植物失败率低于其他两组;差异无统计学意义(P=0.749)。
结论：残端分类类型1的患者表现出明显更好的功能评分（ASES和VAS评分）和前向屈曲；然而，这些差异的临床重要性可能有限.残端分类可用于预测术后临床结果。
