与患者相关的风险因素可预测关节镜下肩袖修复术后的疗效。

Joseph Cline, Dmitri Falkner, Tyler Brolin, Richard Smith, Frederick Azar, Thomas Throckmorton
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引用次数: 0

摘要

本研究的目的是确定患者术前特征是否会对初级关节镜肩袖修复术后的疼痛和功能产生影响。研究确定了至少随访两年的 75 例关节镜下初级肩袖修复术。研究变量包括术前吸烟、使用阿片类药物和酗酒;肥胖;情绪障碍;残疾索赔和工伤赔偿状况。结果测量包括视觉模拟疼痛评分、美国肩肘外科医生(ASES)评分、单一评估数值评价(SANE)评分、活动范围和力量。术前吸烟与疼痛(p = 0.009)、ASES(p = 0.004)和 SANE(p = 0.011)评分的恶化有明显关系。使用阿片类药物在疼痛或功能评分方面没有明显的统计学差异。在长期随访中,酒精的使用确实预示着 ASES 评分的提高(p = 0.046)。其他变量与较差的结果无关。吸烟和术前使用阿片类药物是可改变的风险因素,可在手术前加以纠正,以优化手术效果。(外科骨科进展杂志》33(1):005-009,2024)。
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Patient-Related Risk Factors Predict Outcomes After Arthroscopic Rotator Cuff Repair.

The objective of this study was to determine if preoperative patient characteristics have an effect on pain and function after primary arthroscopic rotator cuff repair. Seventy-five arthroscopic primary rotator cuff repairs with at least 2 years of follow-up were identified. Studied variables were preoperative tobacco, opioid, and alcohol use; obesity; mood disorders; disability claim; and Workers' Compensation status. Outcome measures included visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength. Preoperative smoking was significantly associated with worse pain (p = 0.009), ASES (p = 0.004), and SANE (p = 0.011) scores. Opioid use showed no statistically significant difference in pain or functional scores. Alcohol use did predict improved ASES scores at long-term follow-up (p = 0.046). The other variables were not associated with inferior outcomes. Smoking and preoperative opioid use represent modifiable risk factors that can be corrected before surgery to optimize outcomes. (Journal of Surgical Orthopaedic Advances 33(1):005-009, 2024).

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