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Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis

OBJECTIVE: The effectiveness of arthroscopic rotator cuff repair (ARCR) on rheumatoid arthritis (RA) patients remains a controversial topic. This study investigates the mid‐term outcomes of ARCR in RA patients and identifies the factors influencing clinical efficacy. METHODS: This retrospective stud...

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Autores principales: Zhang, Jie‐chao, Tang, Xiao‐ye, Zhang, Qian, Wang, Xue‐peng, Guo, Zi‐cheng, He, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432454/
https://www.ncbi.nlm.nih.gov/pubmed/37232062
http://dx.doi.org/10.1111/os.13757
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author Zhang, Jie‐chao
Tang, Xiao‐ye
Zhang, Qian
Wang, Xue‐peng
Guo, Zi‐cheng
He, Yong
author_facet Zhang, Jie‐chao
Tang, Xiao‐ye
Zhang, Qian
Wang, Xue‐peng
Guo, Zi‐cheng
He, Yong
author_sort Zhang, Jie‐chao
collection PubMed
description OBJECTIVE: The effectiveness of arthroscopic rotator cuff repair (ARCR) on rheumatoid arthritis (RA) patients remains a controversial topic. This study investigates the mid‐term outcomes of ARCR in RA patients and identifies the factors influencing clinical efficacy. METHODS: This retrospective study enrolled RA patients with small or medium rotator cuff tears (RCTs) between February 2014 and February 2019. Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Constant–Murley scores were collected at each follow‐up time. Ultimately, magnetic resonance imaging (MRI) and X‐ray were employed to assess rotator cuff integrity and progression of shoulder bone destruction, respectively. Statistical methods used two‐way repeated‐measures ANOVA or generalized estimation equations. RESULTS: A total of 157 patients were identified and divided into ARCR (n = 75) and conservative treatment (n = 82) groups. ARCR group continued to be divided into small tear (n = 35) and medium tear (n = 40) groups. At the final, all scores were better in ARCR group than in the conservative treatment group (p < 0.05). A radiographic evaluation of the final follow‐up demonstrated that the progression rate in ARCR group (18.67%) was significantly lower than that of the conservative treatment group (39.02%, p < 0.05). In the comparison of the small tear and medium tear groups, all scores increased significantly after surgery (p < 0.05), and the final follow‐up scores were better than preoperative scores (p < 0.05) but worse than those of the 6‐month postoperative follow‐up (p < 0.05). Comparison between the two groups revealed that all scores of the small tear group were significantly better than those of the medium tear group at 6‐month postoperative follow‐up (p < 0.05). Although the scores of small tear group remained better than those of the medium group at the final postoperative follow‐up, the difference was not statistically significant (p > 0.05). Radiographic assessment of the final follow‐up demonstrated that the progression rate in the small tear group (8.57%) was significantly lower than that in the medium group (27.50%, p < 0.05), and the retear rate of small tear group (14.29%) was significantly lower than that of the medium tear group (35.00%, p < 0.05). CONCLUSION: ARCR could effectively improve the quality of life for RA patients with small or medium RCTs, at least in the medium term. Despite the progression of joint destruction in some patients, postoperative retear rates were comparable to those in the general population. ARCR is more likely to benefit RA patients than conservative treatment.
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spelling pubmed-104324542023-08-18 Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis Zhang, Jie‐chao Tang, Xiao‐ye Zhang, Qian Wang, Xue‐peng Guo, Zi‐cheng He, Yong Orthop Surg Clinical Articles OBJECTIVE: The effectiveness of arthroscopic rotator cuff repair (ARCR) on rheumatoid arthritis (RA) patients remains a controversial topic. This study investigates the mid‐term outcomes of ARCR in RA patients and identifies the factors influencing clinical efficacy. METHODS: This retrospective study enrolled RA patients with small or medium rotator cuff tears (RCTs) between February 2014 and February 2019. Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), and Constant–Murley scores were collected at each follow‐up time. Ultimately, magnetic resonance imaging (MRI) and X‐ray were employed to assess rotator cuff integrity and progression of shoulder bone destruction, respectively. Statistical methods used two‐way repeated‐measures ANOVA or generalized estimation equations. RESULTS: A total of 157 patients were identified and divided into ARCR (n = 75) and conservative treatment (n = 82) groups. ARCR group continued to be divided into small tear (n = 35) and medium tear (n = 40) groups. At the final, all scores were better in ARCR group than in the conservative treatment group (p < 0.05). A radiographic evaluation of the final follow‐up demonstrated that the progression rate in ARCR group (18.67%) was significantly lower than that of the conservative treatment group (39.02%, p < 0.05). In the comparison of the small tear and medium tear groups, all scores increased significantly after surgery (p < 0.05), and the final follow‐up scores were better than preoperative scores (p < 0.05) but worse than those of the 6‐month postoperative follow‐up (p < 0.05). Comparison between the two groups revealed that all scores of the small tear group were significantly better than those of the medium tear group at 6‐month postoperative follow‐up (p < 0.05). Although the scores of small tear group remained better than those of the medium group at the final postoperative follow‐up, the difference was not statistically significant (p > 0.05). Radiographic assessment of the final follow‐up demonstrated that the progression rate in the small tear group (8.57%) was significantly lower than that in the medium group (27.50%, p < 0.05), and the retear rate of small tear group (14.29%) was significantly lower than that of the medium tear group (35.00%, p < 0.05). CONCLUSION: ARCR could effectively improve the quality of life for RA patients with small or medium RCTs, at least in the medium term. Despite the progression of joint destruction in some patients, postoperative retear rates were comparable to those in the general population. ARCR is more likely to benefit RA patients than conservative treatment. John Wiley & Sons Australia, Ltd 2023-05-25 /pmc/articles/PMC10432454/ /pubmed/37232062 http://dx.doi.org/10.1111/os.13757 Text en © 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Clinical Articles
Zhang, Jie‐chao
Tang, Xiao‐ye
Zhang, Qian
Wang, Xue‐peng
Guo, Zi‐cheng
He, Yong
Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title_full Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title_fullStr Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title_full_unstemmed Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title_short Mid‐Term Outcomes of Arthroscopic Rotator Cuff Repair in Patients with Rheumatoid Arthritis
title_sort mid‐term outcomes of arthroscopic rotator cuff repair in patients with rheumatoid arthritis
topic Clinical Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432454/
https://www.ncbi.nlm.nih.gov/pubmed/37232062
http://dx.doi.org/10.1111/os.13757
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