Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair

详细信息    查看全文

• 作者：Martin Tan ; BMed ; MD ; Patrick H. Lam ; PhD ; Brian T.N. Le ; MD ; George A.C. Murrell ; MD ; DPhil ; ^{murrell.g@ori.org.au" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Level III ; Retrospective Cohort Comparison ; Treatment Study
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：25
• 期：1
• 页码：12-21
• 全文大小：321 K

文摘

Patients with rotator cuff tears often recall a specific initiating event (traumatic), whereas many cannot (nontraumatic). It is unclear how important a history of trauma is to the outcomes of rotator cuff repair.

Methods

This question was addressed in a study cohort of 1300 consecutive patients who completed a preoperative questionnaire regarding their shoulder injury and had a systematic evaluation of shoulder range of motion and strength, a primary arthroscopic rotator cuff repair performed by a single surgeon, an ultrasound scan, and the same subjective and objective measurements made of their shoulder 6 months after surgery. Post hoc, this cohort was separated into 2 groups: those who reported no history of trauma on presentation (n = 489) and those with a history of traumatic injury (n = 811).

Results

The retear rate in the group with no history of trauma was 12%, whereas that of the group with a history of trauma was 14% (P = .36). Those patients with a history of shoulder trauma who waited longer than 24 months had higher retear rates (20%) than those who had their surgery earlier (13%) (P = .040).

Conclusion

Recollection of a traumatic initiating event had little effect on the outcome of arthroscopic rotator cuff repair. Duration of symptoms was important in predicting retears if patients recalled a specific initiating event but not in patients who did not recall any specific initiating event. Patients with a history of trauma should be encouraged to have their rotator cuff tear repaired within 2 years.