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Prognostic factors affecting clinical outcomes after arthroscopic rotator cuff repair: importance of functional recovery by 3 months after surgery

医学 肩袖 骨科手术 肩膀 可视模拟标度 外科 多元分析 单变量分析 运动范围 外旋 内科学
作者
Yosuke Nakamura,Masafumi Gotoh,Yasuhiro Mitsui,Hidehiro Nakamura,Hiroki Ohzono,Takahiro Okawa,Naoto Shiba
出处
期刊:Journal of Orthopaedic Surgery and Research [Springer Nature]
卷期号:13 (1) 被引量:18
标识
DOI:10.1186/s13018-018-1014-8
摘要

To examine important factors that affect clinical outcomes following arthroscopic rotator cuff repair (ARCR).Among 163 patients who underwent ARCR, we included 71 shoulders in 71 patients whose progress was monitored for > 2 years, postoperatively. We divided the patients into groups A (scores ≥ 83 points, 59 patients) and B (scores < 83 points, 12 patients) using the Japanese Orthopedic Association (JOA) score at 24 months. We then conducted univariate and multivariate analyses of pre- and postoperative (2 and 3 months, respectively) factors.The mean JOA score for all patients significantly improved from 63.7 ± 11.5 points preoperatively to 90.3 ± 9.6 points at 24 months postoperatively (P < 0.05). However, there were no significant between-group differences in the preoperative scores. In addition, there were no significant differences in the postoperative re-tear rate. Univariate analysis revealed that the range of motion (preoperative abduction and postoperative elevation, abduction, internal rotation, and external rotation), muscle strength (external rotation 3 months postoperatively), postoperative pain level [visual analog scale (VAS) maximum score, 10 points], partial repair, Cofield classification, and preoperative width were significant factors (P < 0.05 for all factors). Multivariate and receiver operating characteristic curve analyses showed that VAS at 2 months postoperatively and elevation at 3 months postoperatively were significant factors.To obtain a JOA score of ≥ 83 points at 24 months postoperatively, following ARCR, a postoperative VAS of < 5 points at 2 months and postoperative elevation of ≥ 110° at 3 months should be achieved.
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