撕裂大小是否影响关节镜肩袖修复术后早期网状物、满意度和功能结果的相关因素？
Does tear size influence factors associated with early retear, satisfaction, and functional outcomes after arthroscopic rotator cuff repair?
摘要(中文译文)
关节镜下肩袖修复术后结构性再撕裂、患者满意度及功能结局的决定因素可能因撕裂大小而异，并影响手术决策。旨在确定撕裂大小是否影响关节镜下肩袖修复术后早期结构性再撕裂、术后满意度及功能结局的相关因素。队列研究；证据等级3级。共1，166例初次关节镜下肩袖修复术按内外侧撕裂大小分为小撕裂（≤10 mm）、中撕裂（11-29 mm）和大撕裂（30-50 mm）。术后6个月，患者接受标准化超声评估结构性再撕裂，并完成5分制满意度量表。测量肩关节力量和活动范围。分别对每个撕裂大小组进行多变量回归分析。与结构性再撕裂的相关因素因撕裂大小而异。在小撕裂中，年龄较大、手术时间较长、前后向撕裂尺寸较大及术前僵硬与再撕裂风险增加相关，而锚钉数量未显示相关性。在中撕裂中，年龄较大、前后向撕裂尺寸较大及术前冈上肌力量较大与再撕裂风险相关，而锚钉数量较多可降低该风险。在大撕裂中，再撕裂与年龄、性别、活动范围及静息痛等因素相关，与锚钉数量无相关性。满意度也因撕裂大小而异：锚钉数量较多与小撕裂中较高的满意度相关，而在中撕裂和大撕裂中，满意度与肩关节相关因素有关。锚钉数量与术后力量或活动范围无一致相关性。与再撕裂、满意度和功能结局相关的因素因撕裂大小而异。锚钉数量较多仅在中撕裂中降低再撕裂风险，且与功能结局关联甚微，支持针对撕裂大小的咨询和手术规划。
Abstract
Determinants of structural retear, patient satisfaction, and functional outcomes after arthroscopic rotator cuff repair may vary by tear size and influence surgical decision-making. To determine whether tear size influences factors associated with early structural retear, postoperative satisfaction, and functional outcomes after arthroscopic rotator cuff repair. Cohort study; Level of evidence, 3. A total of 1,166 primary arthroscopic rotator cuff repairs were categorized by mediolateral tear size as small (≤10 mm), medium (11-29 mm), or large (30-50 mm). At 6 months, patients underwent standardized ultrasound evaluation for structural retear and completed a 5-point satisfaction scale. Shoulder strength and range of motion were measured. Multivariable regression analyses were performed separately for each tear size group. Associations with structural retear differed by tear size. In small tears, older age, longer operative time, greater anteroposterior tear dimension and preoperative stiffness were associated with increased retear risk, while anchors number showed no association. In medium tears, older age, larger anteroposterior tear dimension, and greater preoperative supraspinatus strength were associated with retear risk, whereas greater number of anchors reduced this risk. In large tears, retear was associated with factors including age, sex, range of motion, and pain at rest, with no association with anchors number. Satisfaction also varied by tear size: greater anchors number was associated with higher satisfaction in small tears, whereas in medium and large tears satisfaction was related to shoulder-related factors. The number of anchors was not consistently associated with postoperative strength or range of motion. Factors associated with re-tear, satisfaction and functional outcomes vary by tear size. Greater number of anchors reduced the odds of retear only in medium tears and showed minimal association with functional outcomes, supporting tear size-specific counselling and surgical planning.
如何引用
AMA
Ala' Hawa, Ahmed F Hawwa, James Bilbrough, Victor Chen, Mina Shenouda, George A C Murrell. Does tear size influence factors associated with early retear, satisfaction, and functional outcomes after arthroscopic rotator cuff repair?. PloS one. 2026; doi:10.1371/journal.pone.0350091.
APA
Ala' Hawa, Ahmed F Hawwa, James Bilbrough, Victor Chen, Mina Shenouda, George A C Murrell (2026). Does tear size influence factors associated with early retear, satisfaction, and functional outcomes after arthroscopic rotator cuff repair?. PloS one. https://doi.org/10.1371/journal.pone.0350091
GB/T 7714
Ala' Hawa, Ahmed F Hawwa, James Bilbrough, Victor Chen, Mina Shenouda, George A C Murrell. Does tear size influence factors associated with early retear, satisfaction, and functional outcomes after arthroscopic rotator cuff repair?[J]. PloS one, 2026 doi:10.1371/journal.pone.0350091.
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