ABSTRACT
Objective:To study the influencing factors for shoulder stiffness after rotator cuff tear.Methods:The data of 228 patients were retrospectively analyzed who had been diagnosed with rotator cuff tear by arthroscopic surgery at Department of Articular Surgery, Hospital Affiliated to Chengde Medical College from June 2019 to May 2021. Their baseline data were recorded immediately after admission, including possible risk factors for shoulder stiffness. The patients were divided into a stiffness group and a non-stiffness group based on passive range of motion of shoulder joint. Univariate and multivariate analyses were performed to find out the influencing factors for shoulder stiffness after rotator cuff tear.Results:Preliminary univariate analysis showed that advanced age, smoking history, misdiagnosis history, no standardized physiotherapy history, high body mass index (BMI) and long duration of disease were all likely risk factors for shoulder stiffness in patients with rotator cuff tear ( P<0.05). Multivariate analysis confirmed that advanced age( OR=1.474, 95% CI: 1.013~2.145, P=0.043), smoking history( OR=2.239, 95% CI: 1.147~4.368, P=0.018), no standardized physiotherapy history( OR=0.167, 95% CI: 0.065~0.424, P<0.001), high BMI( OR=3.029, 95% CI: 1.657~5.536, P<0.001) and long duration of disease ( OR=1.775, 95% CI: 1.384~2.276, P<0.001) were the risk factors for shoulder stiffness. Conclusion:Age>60 years, smoking history, misdiagnosis history, no standardized physiotherapy history, high body mass index and long course of disease may be the important influencing factors for shoulder stiffness after rotator cuff tear.
ABSTRACT
Objective To evaluate the clinical efficacy of arthroscopic bursal layer-only double-row suture-bridge repair for delaminated rotator cuff tear which is difficult to reposit in comparison with separate double-layer repair and whole-layer repair.Methods From May 2013 through June 2016,82 patients with delaminated rotator cuff tear difficult to reposit were treated at Department of Joint Surgery,The Affiliate Hospital to Chengde Medical University.They were 47 males and 35 females with a mean age of 53.0 ± 7.9 years.They were divided into 3 groups according to their surgical procedures.In group A,28 cases were treated by arthroscopic whole-layer double-row suture-bridge procedure;in group B,29 cases were treated by arthroscopic separate double-layer double-row suture-bridge procedure;in group C,25 cases were treated by arthroscopic bursal layer-only double-row suture-bridge procedure.The 3 groups were compared in terms of University of California Los Angeles (UCLA) score,American Shoulder and Elbow Surgeons (ASES) score,visual analogue scale (VAS),Constant shoulder score,range of motion of shoulder joint and rotator cuff retear preoperatively and postoperatively.Results The patients in the 3 groups were comparable because their preoperative general data showed no significant significances (P ＞ 0.05).The operation time for groups A,B and C was respectively 105.5 ±5.6 min,117.4 ±6.9 min and 88.0 ±4.2 min,showing significant differences between the 3 groups (P ＜ 0.05).The 82 patients were followed up for 21 to 24 months (average,23.3 months).At 24 months postoperatively,UCLA,ASES,VAS,Constant score,shoulder anteflexion and lateral extorsion were respectively 32.4 ± 2.5,12.8 ± 0.9,1.0 ± 1.1,93.4 ± 5.6,158.3° ± 9.3°and 58.9°±5.0°in group A,32.2±2.5,12.9±1.0,0.9±1.0,92.8±6.0,156.4°±9.5°and 59.3°± 5.6° in groups B,and32.4±2.4,12.9±0.9,0.7±0.9,94.3±5.2,156.0°±9.5°and57.6°°5.4°in group C,showing no significant differences between the 3 groups (P ＞ 0.05).The occurrence of rotator cuff retear in groups A,B and C were respectively 17.9％ (5/28),13.8％ (4/29) and 12.0％ (3/25),showing no significant differences between the 3 groups (P ＞ 0.05).Conclusions In repair of delaminated rotator cuff tear difficult to reposit,although the arthroscopic bursal layer-only double-row suture-bridge repair is similar to conventional arthroscopic whole-layer double-row suture-bridge repair and arthroscopic separate double-layer double-row suture-bridge repair in functional recovery and range of motion of the shoulder and incidence of rotator cuff retear,it can reduce obviously operation time and make the operation easier.