■为了调查术前肩关节活动范围(ROM),会增加术后肩关节僵硬的风险,或者是否与其他术前患者特征相关。
作者回顾性分析了由4名外科医生进行肩袖修复的372个肩膀,2010年1月至2011年1月。所有患者均在3个月和6个月时由2名独立观察者收集ROM,包括主动向前高程(AFE),被动前高程(PFE),和外部旋转(ER),以及主观肩值(SSV)。
■在372名患者的初始队列中,10人失去随访(2.7%),在最少6个月的随访时间内,将362例患者的最终队列用于结局评估。362名患者中,281不需要皮质类固醇浸润,68例接受皮质类固醇浸润治疗肩关节僵硬,无明显原因,13人由于其他原因接受了皮质类固醇浸润。没有一个变量与肩关节僵硬的浸润有关。老年患者的SSV评分更高(β=0.3;95%CI[0.1,0.6];P=0.015),而体力劳动和重复性工人的SSV评分均较低(β=-10.7;95%CI[-15.8,-5.6];P<.001,β=-10.2;95%CI[-15.1,-5.3];P<.001)。
■术后SSV与年龄显著相关,以及手动或重复性工作。此外,术后PFE,AFE,ER与术前PFE显著相关。最后,术后3个月和6个月,肩关节僵硬需要浸润的患者PFE明显降低,AFE,和ER与不需要浸润的患者相比。
■IV,案例系列。
UNASSIGNED: To investigate whether the preoperative shoulder range of motion (ROM), would increase the risk of postoperative shoulder stiffness, or whether it would be associated with other preoperative patient characteristics.
UNASSIGNED: The authors retrospectively analysed the 372 shoulders that underwent rotator cuff repair by 4 surgeons, between January 2010 and January 2011. All patients were followed up at 3 and 6 months by 2 independent observers to collect the ROM, including active forward elevation (AFE), passive forward elevation (PFE), and external rotation (ER), as well as subjective shoulder value (SSV).
UNASSIGNED: Of the initial cohort of 372 patients, 10 were lost to follow-up (2.7%), leaving a final cohort of 362 patients available for outcome assessment at a minimum follow-up of 6 months. Of the 362 patients, 281 did not require corticosteroid infiltration, 68 received corticosteroid infiltrations for shoulder stiffness with no apparent cause, and 13 received corticosteroid infiltrations for other reasons. None of the variables were associated with infiltration for shoulder stiffness. Older patients had greater SSV scores (β = 0.3; 95% CI [0.1, 0.6]; P = .015), while both manual and repetitive workers had lower SSV scores (β = -10.7; 95% CI [-15.8, -5.6]; P < .001, and β = -10.2; 95% CI [-15.1, -5.3]; P < .001).
UNASSIGNED: Postoperative SSV was significantly associated with age, as well as manual or repetitive work. Furthermore, postoperative PFE, AFE, and ER were significantly associated with preoperative PFE. Finally, at 3 and 6 months postoperative, patients who required infiltration for shoulder stiffness had significantly lower PFE, AFE, and ER compared to patients who did not require infiltration.
UNASSIGNED: IV, Case series.