Risk factors analysis of retear after arthroscopic suture repair of rotator cuff injury

doi:10.3877/cma.j.issn.2095-5790.2022.01.003

Abstract

Abstract:

Background

Rotator cuff tear refers to the injury of rotating muscles around shoulder joint. The majority of patients were middle-aged and elderly people. The common causes of tear include trauma, exercise, degeneration of rotator cuff tendon and abnormal shape of shoulder acromion. Arthroscopic suture repair is one of the main methods to treat rotator cuff injury at present, but literatures report that there is still 11%-94% retear rate after arthroscopic repair.

Objective

To evaluate the preoperative factors of rotator cuff retear after the arthroscopic repair and to provide proper surgical treatment options.

Methods

From January 2015 to January 2019, 624 consecutive patients with full-thickness rotator tear who underwent arthroscopic repair were retrospectively analyzed. Binary Logistic regression analysis was used to investigate the risk factors for rotator cuff retear after operation.

Results

The course of disease>3 months, preoperative tear size>3 cm, single-row fixation, high grade of fatty infiltration (Goutallier ≥3 grade) , history of diabetes and postoperative trauma were all high risk factors for rotator cuff retear (P<0.05) . Age, gender, dominant arm, smoking history, or competitive sports were not related (P>0.05) .

Conclusion

Long duration of disease, large tear size, high grade of fatty degeneration, single-row fixation, history of diabetes and postoperative trauma are high independent risk factors for rotator cuff retear.

Key words: Rotator cuff, Retear, Arthroscopy, Post-operation, Risk factors

Yuqi Chen, Lei Zhang, Huisheng Shi, Qingxin Han, Jin Sun, Jia Ma, Xiaohua Liu, Bo Jiang, Yan Li, Dingyuan Fan, Sheng Zhang. Risk factors analysis of retear after arthroscopic suture repair of rotator cuff injury[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2022, 10(01): 7-13.

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Figures/Tables 7

References 34

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因素		愈合	再撕裂	OR值	95% CI		P值
因素		（n＝557）	（n＝67）	OR值	下限	上限	P值
年龄
	<65岁	421	43
	≥65岁	136	24	0.842	0.102	6.246	0.875
性别
	男	229	32
	女	328	35	1.373	0.710	3.616	0.585
病程
	≤3个月	251	19
	>3个月	306	48	3.875	1.025	8.419	0.022
优势肩
	否	238	23
	是	319	44	1.612	0.667	3.432	0.199
术前撕裂大小
	小	91	7
	中	294	16	1.101	0.931	7.545	0.072
	大	125	26	2.412	1.131	5.733	0.043
	巨大	47	18	7.354	1.335	25.427	<0.001
手术方式
	双排	412	40
	单排	145	27	5.145	1.310	21.279	0.027
术前肌肉质量
	0级	67	6
	Ⅰ级	202	13	1.199	0.914	1.337	0.347
	Ⅱ级	182	16	1.582	0.405	5.149	0.430
	Ⅲ级	73	20	7.034	2.981	24.180	0.011
	Ⅳ级	33	12	15.239	6.312	34.866	<0.001
术后外伤史
	无	546	63
	有	11	4	2.033	1.178	3.707	0.017
吸烟史
	无	421	49
	有	136	18	1.207	0.278	3.059	0.865
糖尿病史
	无	433	46
	有	124	21	2.498	1.150	5.185	0.003
从事竞技运动
	否	459	56
	是	98	11	1.103	0.265	4.822	0.918

因素		愈合	再撕裂	OR值	95% CI		P值
因素		（n＝557）	（n＝67）	OR值	下限	上限	P值
年龄
	<65岁	421	43
	≥65岁	136	24	0.842	0.102	6.246	0.875
性别
	男	229	32
	女	328	35	1.373	0.710	3.616	0.585
病程
	≤3个月	251	19
	>3个月	306	48	3.875	1.025	8.419	0.022
优势肩
	否	238	23
	是	319	44	1.612	0.667	3.432	0.199
术前撕裂大小
	小	91	7
	中	294	16	1.101	0.931	7.545	0.072
	大	125	26	2.412	1.131	5.733	0.043
	巨大	47	18	7.354	1.335	25.427	<0.001
手术方式
	双排	412	40
	单排	145	27	5.145	1.310	21.279	0.027
术前肌肉质量
	0级	67	6
	Ⅰ级	202	13	1.199	0.914	1.337	0.347
	Ⅱ级	182	16	1.582	0.405	5.149	0.430
	Ⅲ级	73	20	7.034	2.981	24.180	0.011
	Ⅳ级	33	12	15.239	6.312	34.866	<0.001
术后外伤史
	无	546	63
	有	11	4	2.033	1.178	3.707	0.017
吸烟史
	无	421	49
	有	136	18	1.207	0.278	3.059	0.865
糖尿病史
	无	433	46
	有	124	21	2.498	1.150	5.185	0.003
从事竞技运动
	否	459	56
	是	98	11	1.103	0.265	4.822	0.918

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