The time for functional recovery after arthroscopic rotator cuff repair:: Correlation with tendon healing controlled by computed tomography arthrography
The time for functional recovery after arthroscopic rotator cuff repair:: Correlation with tendon healing controlled by computed tomography arthrography
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DOI：
10.1016/j.arthro.2007.07.023
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发表时间：
2008-01-01
影响因子：
4.7
通讯作者：
Kalra, Kunal
中科院分区：
文献类型：
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作者：
Charousset, Christophe;Grimberg, Jean;Kalra, Kunal
目的：我们调查了关节镜下肩袖修复术后功能恢复多久才能显着以及对肌腱愈合的影响。方法：对2001年1月至2003年12月期间经关节镜修复的114例全层肩袖撕裂患者进行前瞻性研究。所有患者在术后3、6、12、24个月及末次随访时均采用Constant评分系统进行评估。术后 6 个月进行计算机断层扫描关节造影，以研究肌腱愈合的进展情况。结果：Constant 评分从术后第三个月显着改善 (P < .0001) 到第十二个月，之后稳定下来 (P < .0001)。最后一次随访（31 个月）时，平均评分为 80.1 分（范围：50 至 95 分）。女性 (P < .0001)、上肢繁重工作 (P < .0001)、骨质量差 (P = .039) 和未愈合 (P = .002) 是阴性预测因素。特别是，肌腱不愈合会导致第十二个月后的结果恶化。结论：本研究中进行的肩袖损伤的关节镜修复在功能恢复方面取得了非常好的效果。我们的研究表明，术后 3 个月即可恢复功能，并在第一年进一步改善，随后趋于稳定。我们发现，女性、上肢繁重的工作、骨质质量差和肌腱愈合不良都与结果呈负相关。出现延迟的患者与其他患者不同，他们的临床进展显示第一年的恒定评分显着上升，此后评分下降。证据级别：IV 级，治疗病例系列。
Purpose: We investigated how soon postoperative functional recovery became significant after arthroscopic rotator cuff repair and the influence of tendon healing. Methods: We conducted a prospective study on 114 cases of full-thickness rotator cuff tears arthroscopically repaired from January 2001 to December 2003. All patients were evaluated by the Constant scoring system at 3, 6, 12, and 24 months after surgery and at last follow-up. Computed tomography arthrography was done at 6 months postoperatively to study the progression of tendon healing. Results: The Constant score significantly improved from the third month after surgery (P < .0001) until the twelfth month, after which it stabilized (P < .0001). At last follow-up (31 months), the mean score was 80.1 points (range, 50 to 95 points). Female sex (P < .0001), upper-limb heavy work (P < .0001), poor bone quality (P = .039), and absence of healing (P = .002) were negative predictive factors. In particular, the absence of tendon healing leads to a worsening of the results from the twelfth month onward. Conclusions: Arthroscopic repair of rotator cuff lesions as performed in this study gives very good results in terms of functional recovery. Our study showed functional recovery as early as 3 months after surgery and further improvement over the first year, followed by stabilization. We found that female sex, upper-limb heavy work, poor bone quality, and lack of tendon healing were all negatively associated with outcome. Patients presenting with a retear differed from the other patients, in that their clinical progression showed a significant rise in the Constant score over the first year, with a lowering of the score thereafter. Level of Evidence: Level IV, therapeutic case series.