目的:急性创伤性肩袖撕裂和慢性非创伤性肩袖撕裂是病因上可区分的实体。然而,缺乏比较这两种泪液的泪液特征和结果的前瞻性研究.这项研究的目的是比较泪液的特征,临床和功能结果,和磁共振成像(MRI)评估的肌腱愈合,在创伤性和非创伤性肩袖撕裂之间。
方法:根据损伤史将MRI证实的肩袖撕裂分为两组:第1组28例创伤性撕裂,第2组33例非创伤性肩袖撕裂。比较两组术前泪液特征(泪液大小、肌肉萎缩,脂肪变性),运动范围,肩关节外展和外旋的力量,功能结果,和MRI上的肌腱完整性,手术后2年。
结果:术后平均外展活动范围(p=0.005),外展强度(p=0.013),外转强度(p=0.027),加州大学洛杉矶分校得分(p<0.001),恒定分数(p=0.002),与第2组相比,第1组的美国肩肘外科医生评分(p=0.028)和疼痛视觉模拟量表(p=0.02)明显更好。与第2组相比,第1组MRI上袖带的术后结构完整性更好,但该值未达到统计学意义(p=0.13)。
结论:这项研究的结果表明,创伤性泪液会影响年轻患者,而泪液尺寸较大,他们有较小的肌肉萎缩,脂肪变性,和肌腱缩回。与非创伤性眼泪相比,创伤性眼泪治疗后的功能结果更好。撕裂和肌腱回缩的慢性对创伤性袖口撕裂的愈合产生负面影响。发现肌肉萎缩与非创伤性眼泪的愈合不良有关。然而,泪液大小与愈合无关.
方法:II,前瞻性队列研究。
OBJECTIVE: Acute traumatic and chronic non-traumatic rotator cuff tears are etiologically distinguishable entities. However, prospective studies comparing tear characteristics and outcomes between these two types of tears are lacking. The purpose of this study was to compare the tear characteristics, clinical and functional outcomes, and tendon healing as assessed on magnetic resonance imaging (MRI), between traumatic and non-traumatic rotator cuff tears.
METHODS: MRI proven rotator cuff tears were allocated into two groups according to the history of injury: Group 1 included 28 patients with traumatic tears and group 2 included 33 patients of non-traumatic cuff tears. Both the groups were compared for preoperative tear characteristics (tear size, muscle atrophy, fatty degeneration), range of motion, strength of shoulder abduction and external rotation, functional outcomes, and tendon integrity on MRI, 2 years after the surgery.
RESULTS: Postoperative mean active range of abduction (p = 0.005), abduction strength (p = 0.013), external rotation strength (p = 0.027), University of California at Los Angeles score (p < 0.001), Constant score (p = 0.002), American Shoulder and Elbow Surgeons scores (p = 0.028) and visual analog scale for pain (p = 0.02) were significantly better in group 1 as compared to group 2. The postoperative structural integrity of the cuff on MRI was better in group 1 as compared to group 2, but the values did not reach statistical significance (p = 0.13).
CONCLUSIONS: Findings from this study suggest that traumatic tears affect younger patients and while having a larger tear size, they have lesser muscle atrophy, fatty degeneration, and tendon retraction. Functional outcomes are better after treatment of traumatic tears as compared to non-traumatic tears. Chronicity of the tear and tendon retraction negatively affected healing in traumatic cuff tears. Muscle atrophy was found to be associated with poorer healing in non-traumatic tears. However, tear size was not associated with healing.
METHODS: II, Prospective cohort study.