Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

BACKGROUND: Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors-including age, sex, and tear severity-have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial. PURPOSE: To investigate the influence of tear etiology (degenerative vs traumatic) on functional and structural outcomes in patients with supraspinatus tendon tears. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Patients undergoing ARCR from 19 centers were prospectively enrolled between June 2020 and November 2021. Full-thickness, nonmassive tears involving the supraspinatus tendon were included. Tears were classified as degenerative (chronic shoulder pain, no history of trauma) or traumatic (acute, traumatic onset, no previous shoulder pain). Range of motion, strength, the Subjective Shoulder Value, the Oxford Shoulder Score (OSS), and the Constant-Murley Score (CMS) were assessed before (baseline) and 6 and 12 months after ARCR. The Subjective Shoulder Value and the OSS were also determined at the 24-month follow-up. Repair integrity after 12 months was documented, as well as additional surgeries up to the 24-month follow-up. Tear groups were compared using mixed models adjusted for potential confounding effects. RESULTS: From a cohort of 973 consecutive patients, 421 patients (degenerative tear, n = 230; traumatic tear, n = 191) met the inclusion criteria. The traumatic tear group had lower mean baseline OSS and CMS scores but significantly greater score changes 12 months after ARCR (OSS, 18 [SD, 8]; CMS, 34 [SD,18] vs degenerative: OSS, 15 [SD, 8]; CMS, 22 [SD, 15]) (P < .001) and significantly higher 12-month overall scores (OSS, 44 [SD, 5]; CMS, 79 [SD, 9] vs degenerative: OSS, 42 [SD, 7]; CMS, 76 [SD, 12]) (P≤ .006). At the 24-month follow-up, neither the OSS (degenerative, 44 [SD, 6]; traumatic, 45 [SD, 6]; P = .346) nor the rates of repair failure (degenerative, 14 [6.1%]; traumatic 12 [6.3%]; P = .934) and additional surgeries (7 [3%]; 7 [3.7%]; P = .723) differed between groups. CONCLUSION: Patients with degenerative and traumatic full-thickness supraspinatus tendon tears who had ARCR show satisfactory short-term functional results. Although patients with traumatic tears have lower baseline functional scores, they rehabilitate over time and show comparable clinical results 1 year after ARCR. Similarly, degenerative and traumatic rotator cuff tears show comparable structural outcomes, which suggests that degenerated tendons retain healing potential.

Síndrome metabólico, obesidad y actividad física en el sur de Ecuador / Metabolic syndrome, obesity and physical activity insouthern of Ecuador

Contexto: En Ecuador, el síndrome metabólico (SM) en adultos tuvo para el 2012 una prevalencia de 27 % a nivel nacional, según criterios de la International Diabetes Federation(IDF)y se asocia a obesidad y sedentarismo. Objetivo: Determinar la relación entre SM con actividad física e índice de masa corporal (IMC). studio transversal, descriptivo-observacional. Lugar y sujetos: 326 trabajadores universitarios de Loja, Ecuador, con edad promedio de 39,6 años (DS 8,58). Mediciones principales: variables antropométricas y parámetros séricos para diagnóstico de SM y de IMC. El International Physical Activity Questionnaire(IPAQ) se empleó para medir actividad física. Resultados: La prevalencia global de SM fue 16,9 %, según criterios NCEP/ATP III(National Cholesterol Education Program ́s Adults Treatment Panel III) y de 27,3 % por los de IDF. El SM fue más frecuente en obesos, en mujeres y en el grupo etario mayor a 50 años. Los parámetros más frecuentes de SM fueron colesterol-HDL(c-HDL) disminuido e hipertrigliceridemia. 2/19Revista científica digital INSPILIP Código ISSN 2588-0551DOI: 10.31790/inspilip.v3i1.80.g149Revista científica INSPILIP. Disponible en: http://www.inspilip.gob.ec/Junio de 2019Los hombres tuvieron valores significativamente (p<0,001) más elevados de todos los parámetros de SM, excepto glicemia. Se encontró asociación (p<0,001) entre SM e IMC, pero no con nivel de actividad física. Conclusión: La prevalencia de SM en trabajadores universitarios de Loja, Ecuador, es similar a la prevalencia nacional. El sobrepeso y la obesidadestán asociados a SM, acompañado principalmente de dislipidemia, a pesar de un nivel de actividad física entre moderada e intensa, todo lo cual destaca la importancia de implementar medidas de prevención, destacando los aspectos nutricional.

Context: In Ecuador, the metabolic syndrome (MS) in adults, had a prevalence of 27% nationwide by 2012 according to criteria of the International Diabetes Federation (IDF) and is associated with obesity and sedentary lifestyle. Objective:To determine the relationship between SM with physical activity and body mass index (BMI). Design:Cross-sectional, descriptive-observational study. Place and subjects: 326 university workers from Loja, Ecuador, with an average age of 36.6 years (SD 8.58). Main measurements:anthropometric measurements and serum parameters for diagnosis of MS and BMI. The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity. Results:The global prevalence of MS was 16.9% according to NCEP / ATP III criteria (National Cholesterol Education Program's Adults Treatment Panel III) and 27.3% by IDF. The SM was more frequent in obese, in women and in the age group over 50 years. The most frequent parameters of MS were decreased HDL-Cholesterol and hypertriglyceridemia. Men had significantly higher values (p <0.001) of all SM parameters, except glycaemia. Association was found (p <0.001) between SM and BMI, but not with physical activity level. Conclusion:the prevalence of MS among university workers in Loja, Ecuador, is similar to the national prevalence. Overweight and obesity are associated with MS, mainly accompanied by dyslipidemia, despite a moderate to intense level of physical activity, all of which highlights the importance of implementing preventive measures, highlighting the nutritional aspects.