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首页> 美国卫生研究院文献>Scientific Reports >The Effect of Critical Shoulder Angle on Clinical Scores and Retear Risk After Rotator Cuff Tendon Repair at Short-term Follow Up
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The Effect of Critical Shoulder Angle on Clinical Scores and Retear Risk After Rotator Cuff Tendon Repair at Short-term Follow Up

机译：肩Should突短时间随访对肩袖肌腱修复后临床评分和后遗风险的影响

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The authors aimed to investigate whether standard acromioplasty can reduce critical shoulder angle (CSA) effectively and to investigate the effects of postoperative CSA on the clinical outcomes and retear rates. Patients are divided in to three groups: group 1 (24 patients): CSA under 35° before surgery, group 2 (25 patients): CSA over 35° before surgery and under 35° after surgery and group 3 (17 patients): CSA over 35° before and after surgery. Standard acromioplasty was performed if CSA is over 35 and no acromioplasty was performed if the CSA is already under 35. Preoperative and postoperative CSAs, UCLA, Constant-Murley clinical score and visual analog scale (VAS) pain score were measured. The size of the rotator cuff tear was classified by the Patte classification in preoperative MRI and the quality of the repair was evaluated as retear if discontinuity detected in the postoperative first year MRI. There were 31 female and 35 male patients with a mean age of 59.3 ± 4.5 years (range, 48–68) at the time of surgery. The mean CSA is reduced from 37.8° ± 1.4 to 34.9° ± 1.2 (p < 0.001) significantly for patients who underwent acromioplasty. In 25 (59.5%) of the 42 patients, the CSA was reduced to under 35°, whereas in the other 17 (40.5%) patients, it remained over 35°. The mean Constant and UCLA score was 46.4 ± 6.6; 18.5 ± 1.6 preoperatively and 82.4 ± 6.2; 31.1 ± 1.9 postoperatively respectively (p < 0,001). The mean VAS decreased from 4.94 ± 1.09 to 0.79 ± 0.71 (p < 0.001). No Clinical difference was seen between patients in which CSA could be reduced under 35° or not in terms of Constant-Murley score, UCLA and VAS score. Retear was observed in 2 (8.3%) patients in group 1, in 4 (16%) patients in group 2 and in 3 patients (17.6%) in group 3. There was not any significant difference between the patients who had retear or not in terms of neither the CSA values nor the change of CSA after the surgery. Standard acromioplasty, which consists of an anterolateral acromial resection, can reduce CSA by approximately 3°. This is not always sufficient to decrease the CSAs to the favorable range of 30°–35°. In addition, its effect on clinical outcomes does not seem to be noteworthy.
机译：作者旨在调查标准的肩峰成形术是否可以有效降低肩critical角（CSA），并探讨术后CSA对临床结局和后遗率的影响。患者分为三组：第1组（24位患者）：手术前35°以下的CSA；第2组（25位患者）：手术前35°以上且术后35°以下的CSA；第3组（17位患者）：CSA手术前后超过35°。如果CSA超过35，则进行标准的肩峰成形术；如果CSA已经低于35，则不进行肩峰成形术。测量术前和术后CSA，UCLA，Constant-Murley临床评分和视觉模拟评分（VAS）疼痛评分。术前MRI中按Patte分类法对肩袖撕裂的大小进行分类，如果在术后第一年MRI中检测到不连续性，则将修复质量评估为可撤出。手术时有31例女性和35例男性患者，平均年龄为59.3±4.5岁（范围48-68）。对于行肩部置换术的患者，平均CSA值从37.8°±1.4降低到34.9°±1.2（p <0.001）。 42例患者中有25例（59.5％）的CSA降低到35°以下，而其他17例（40.5％）的患者的CSA保持在35°以上。平均常数和UCLA评分为46.4±6.6。术前分别为18.5±1.6和82.4±6.2;术后分别为31.1±1.9（p <0.001）。平均VAS从4.94±1.09降至0.79±0.71（p <0.001）（p <0.001）。在Constant-Murley评分，UCLA和VAS评分方面，CSA可以降低至35°以下或不降低的患者之间无临床差异。第一组的2名患者（8.3％），第二组的4名患者（16％）和第三组的3名患者（17.6％）出现了退缩。无论是CSA值，还是手术后CSA的变化。标准的肩峰成形术由前外侧肩峰切除术组成，可使CSA降低约3°。这并不总是足以将CSA降低到30°–35°的有利范围。此外，它对临床结果的影响似乎并不值得注意。

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