BACKGROUND Most patients return successfully to shoulder involving sports or activity after rotator cuff repairs. It has not been decided yet whether postoperative participation in shoulder activity adds to the risk of retear. PURPOSE/HYPOTHESIS The purpose was to verify whether patients who participate in shoulder activities after rotator cuff repair have a higher risk of structural failure than nonactive patients and to investigate the relationship between postoperative shoulder function and tendon integrity in active and nonactive patients. The hypotheses were that (1) active patients have a higher retear rate than nonactive patients and (2) structural failure is associated with worse functional outcomes in active patients. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS A cohort study was performed using 145 patients who underwent arthroscopic rotator cuff repair from 2015 to 2017. Functional assessments and magnetic resonance imaging were performed at least 24 months postoperatively. Shoulder activities since 6 months after surgery were rated in 4 categories (sports, job, activities of daily life, and weight of general lifting) as sedentary, light, moderate, or strenuous. The activity level of each patient was defined by the highest rated category. Patients who were involved in light, moderate, and strenuous activity were identified as active for the present study, and the rest were defined as sedentary. The proportion of retears between groups and the functional conditions between retorn and intact tendons were compared. RESULTS A total of 48 patients were enrolled in the active group, and 97 were enrolled in the sedentary group. The active group demonstrated a significantly higher retear rate than the sedentary group (27.1% vs 11.3%, respectively; P = .016; risk ratio, 2.39 [95% CI, 1.16-4.93]). In the active group, patients with retears showed higher visual analog scale scores for pain, decreased abduction strength, and lower shoulder functional scores (American Shoulder and Elbow Surgeons score, Fudan University Shoulder Score, and Constant-Murley score) than those with healed tendons, whereas in the sedentary group, functional outcomes were generally similar across patients with and without retears. CONCLUSION Shoulder activity after the early postoperative period was associated with a high risk of retears in patients who underwent rotator cuff repair. A correlation between inhibited function and structural failure was detected but only in active patients, while sedentary patients with retears retained functional improvements similar to those with intact tendons.

中文翻译：

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肩袖修复后的泪液和伴随的功能障碍：肩部活动是一个危险因素。

背景技术大多数患者在肩袖修复后成功地回到肩上进行运动或活动。术后参与肩部活动是否会增加后退风险尚未确定。目的/假设目的是验证肩袖修复后参与肩部活动的患者是否比非活动性患者具有更高的结构衰竭风险，并研究活动和非活动性患者术后肩功能与肌腱完整性之间的关系。假设是：（1）活动患者比非活动患者具有更高的后退率；（2）结构性衰竭与活动患者较差的功能预后相关。研究设计队列研究；证据水平3。方法对2015年至2017年行关节镜下肩袖修补术的145例患者进行了一项队列研究。术后至少24个月进行了功能评估和磁共振成像。术后六个月以来的肩膀活动分为久坐，轻度，中度或剧烈四个等级（运动，工作，日常生活活动和一般举重）。每个患者的活动水平由最高评分类别定义。参与轻度，中度和剧烈运动的患者在本研究中被确定为活跃，其余患者定义为久坐。比较了各组之间的后退比例以及后退和完整肌腱之间的功能状况。结果活动组共纳入48例患者，久坐组中有97人入选。活动组表现出比久坐组显着更高的后退率（分别为27.1％和11.3％； P = .016；风险比为2.39 [95％CI，1.16-4.93]）。在活动组中，与治愈后的肌腱患者相比，有眼泪的患者在疼痛，外展强度降低和肩部功能评分（美国肩肘外科医师评分，复旦大学肩部评分和恒力默利评分）方面具有较高的视觉模拟量表评分， ，而在久坐组中，有和没有后壁的患者的功能结局通常相似。结论术后早期肩部活动与进行肩袖修复的患者发生高眼泪的风险有关。