Background:

The New Zealand Rotator Cuff Registry represents the largest prospective cohort of rotator cuff repairs. Despite this, there are limited medium- to long-term data of rotator cuff repair outcomes.

Purpose:

To (1) analyze the pain and functional outcomes of a large cohort of primary rotator cuff repairs and (2) evaluate the effect of patient factors and tear characteristics on medium-term outcomes.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

This was a multicenter, multisurgeon prospective cohort study of rotator cuff repairs from March 2009 until December 2010. Surgical data were collected by the operating surgeon. Primary outcome measures were the Flexilevel Scale of Shoulder Function (FLEX-SF) and a pain score, collected at baseline, 6, 12, and 24 months, and 5 years. Univariate and multivariate analyses were carried out.

Results:

Overall, 2533 primary rotator cuff repairs were analyzed with 81% follow-up at 5 years. The mean age of the cohort was 56 years. In the 2052 patients with final follow-up data, improvement on the FLEX-SF continued until 24 months postoperatively and remained high at 5 years. Mean improvement in FLEX-SF from baseline to 5 years was 15 points. Patients aged >70 years had lower FLEX-SF scores but no significant difference in improvement compared with patients ≤70 years. The mean anteroposterior tear size was 2.2 cm, and on multivariate analysis, tears >4 cm had worse 5-year FLEX-SF scores. If the affected tendon was easily reducible, there was no difference in FLEX-SF score for retracted or larger tears compared with smaller tears. The reoperation rate was 6.2%.

Conclusion:

Results indicated that rotator cuff repairs provide a sustained clinical improvement out past 5 years. Most functional improvement and pain relief occurred within the first 6 months, but improvement continued out to 24 months. Most population groups did well after rotator cuff repairs, including those >70 years. Tear size >4 cm and tendon reducibility correlated with outcome. Even patients with large tear sizes had clinically significant improvement in FLEX-SF scores after repair.

中文翻译：

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年龄、人口统计和撕裂特征会影响肩袖修复后的结果吗？超过 2000 例肩袖修复的 5 年随访结果

背景：

新西兰肩袖登记处代表了最大的肩袖修复前瞻性队列。尽管如此，肩袖修复结果的中长期数据有限。

目的：

（1）分析大量原发性肩袖修复的疼痛和功能结果，（2）评估患者因素和撕裂特征对中期结果的影响。

学习规划：

队列研究；证据水平，2。

方法：

这是一项从 2009 年 3 月到 2010 年 12 月进行的肩袖修复的多中心、多外科医生前瞻性队列研究。手术数据由手术外科医生收集。主要结果测量是在基线、6、12、24 个月和 5 年时收集的肩功能弹性水平量表 (FLEX-SF) 和疼痛评分。进行了单变量和多变量分析。

结果：

总体而言，对 2533 例原发性肩袖修复进行了分析，5 年随访率为 81%。该队列的平均年龄为 56 岁。在有最终随访数据的 2052 名患者中，FLEX-SF 的改善一直持续到术后 24 个月，并在 5 年时保持较高水平。FLEX-SF 从基线到 5 年的平均改善为 15 分。与≤70 岁的患者相比，70 岁以上的患者 FLEX-SF 评分较低，但在改善方面没有显着差异。平均前后撕裂大小为 2.2 cm，在多变量分析中，>4 cm 的撕裂具有更差的 5 年 FLEX-SF 评分。如果受影响的肌腱易于复位，则缩回或较大撕裂与较小撕裂相比，FLEX-SF 评分没有差异。再手术率为6.2%。

结论：

结果表明，肩袖修复提供了过去 5 年的持续临床改善。大多数功能改善和疼痛缓解发生在前 6 个月内，但改善持续到 24 个月。大多数人群在肩袖修复后表现良好，包括> 70岁的人群。撕裂大小 > 4 cm 和肌腱可还原性与结果相关。即使是撕裂大小较大的患者，修复后 FLEX-SF 评分也有临床显着改善。