肩袖损伤关节镜下缝合修复术后再撕裂的风险因素分析

目的研究肩袖损伤肩关节镜下缝合术后发生再撕裂的风险因素,为术前评估术后再撕裂风险的大小及手术方式提供临床参考。 方法回顾性分析2015年1月至2019年1月624例在本科因"肩袖全层撕裂"住院并接受肩关节镜下肩袖缝合修复术患者的临床资料。使用二元Logistic回归分析方法研究术后肩袖再撕裂的风险因素。 结果病程>3个月、术前撕裂范围>3 cm、单排固定方式、脂肪浸润程度较高（Goutallier3级及以上）、糖尿病史及术后外伤均为术后肩袖再撕裂的高风险因素（P<0.05）。患者年龄、性别、是否优势肩、吸烟史、是否从事竞技运动等与肩袖术后再撕裂无明显相关（P>0.05）。 结论病程长、术前撕裂范围大、单排固定方式、肌肉脂肪浸润程度较高、糖尿病史及术后外伤均可能造成术后肩袖发生再撕裂。

Risk factors analysis of retear after arthroscopic suture repair of rotator cuff injury

BackgroundRotator cuff tear refers to the injury of rotating muscles around shoulder joint. The majority of patients were middle-aged and elderly people. The common causes of tear include trauma, exercise, degeneration of rotator cuff tendon and abnormal shape of shoulder acromion. Arthroscopic suture repair is one of the main methods to treat rotator cuff injury at present, but literatures report that there is still 11%-94% retear rate after arthroscopic repair. ObjectiveTo evaluate the preoperative factors of rotator cuff retear after the arthroscopic repair and to provide proper surgical treatment options. MethodsFrom January 2015 to January 2019, 624 consecutive patients with full-thickness rotator tear who underwent arthroscopic repair were retrospectively analyzed. Binary Logistic regression analysis was used to investigate the risk factors for rotator cuff retear after operation. ResultsThe course of disease>3 months, preoperative tear size>3 cm, single-row fixation, high grade of fatty infiltration (Goutallier ≥3 grade) , history of diabetes and postoperative trauma were all high risk factors for rotator cuff retear (P<0.05) . Age, gender, dominant arm, smoking history, or competitive sports were not related (P>0.05) . ConclusionLong duration of disease, large tear size, high grade of fatty degeneration, single-row fixation, history of diabetes and postoperative trauma are high independent risk factors for rotator cuff retear.