BACKGROUND:Fatty infiltration (FI) compromises outcomes of rotator cuff repairs. Most clinicians consider FI of the infraspinatus, whether it is torn or intact, because it is most rapidly affected. The purpose of this study was to report long-term outcomes of isolated supraspinatus repairs and to determine their associations with FI of the infraspinatus and supraspinatus. METHODS:The records of 182 patients who underwent repair of isolated supraspinatus tears and had preoperative magnetic resonance imaging were retrieved. Of these, 147 patients were evaluated at 10 years' follow-up using the Constant score and magnetic resonance imaging scans. RESULTS:Preoperative FI was greater in the supraspinatus (52% stage ≥1) than in the infraspinatus (29% stage ≥1). The 10-year Constant scores were influenced by FI of the supraspinatus (P = .006) but not of the infraspinatus (P = .422). Multivariable regression confirmed that Constant scores were significantly lower for female patients, repetitive work, and stage 1 and stage 2 FI of the supraspinatus in addition to open surgery. Retear rates (Sugaya types IV-V) were also influenced by FI of the supraspinatus (P = .001) but not of the infraspinatus (P = .979). Shoulders with supraspinatus FI at stages 0, 1, and 2 had retear rates of 10%, 22%, and 31%, respectively. Multivariable regression affirmed that the odds of retears are significantly increased by both stage 1 and stage 2 FI of the supraspinatus. CONCLUSIONS:The Constant scores and retear rates were significantly associated with FI of the torn supraspinatus (stage ≥1) but not of the intact infraspinatus. The authors recommend that rapid surgical intervention be considered, before accumulation of fat, especially for young, active patients.

译文

背景:脂肪浸润(FI)损害了肩袖修复的效果。大多数临床医生都考虑到下鼻窦的FI,无论其是撕裂的还是完整的,因为它受到的影响最为迅速。这项研究的目的是报告孤立的上棘修复的长期结果,并确定它们与下脊柱和上棘的FI的关系。
方法:检索182例行孤立性上睑上睑裂孔修复并术前进行磁共振成像的患者的病历。在其中的147位患者中,使用Constant评分和磁共振成像扫描在10年的随访中对其进行了评估。
结果:术前FI在棘上肌(52%≥1)大于在鼻下肌(29%≥1)。 10年常数评分受脊柱上方FI的影响(P = .006),但不影响椎下肌的FI(P = .422)。多变量回归证实,除开放手术外,女性患者,重复性工作以及棘上肌第1期和第2期FI的恒定评分明显更低。退缩率(Sugaya IV-V型)也受棘上肌FI的影响(P = .001),而不受鞘下肌FI的影响(P = .979)。棘上棘FI在0、1和2期的肩后退率分别为10%,22%和31%。多变量回归证实,上棘的第1阶段和第2阶段FI均使后遗几率显着增加。
结论:恒定评分和后退率与棘上棘(≥1期)的FI显着相关,而与完整的鼻下肌无关。作者建议在脂肪积聚之前考虑快速外科手术干预,尤其是对于年轻活跃的患者。

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