| Objective: 1.To study the clinical effect of arthroscopic rotator cuff repair in the treatment of chronic rotator cuff tears.2.To study the correlation between preoperative pain and tear size,preoperative shoulder function,postoperative pain and postoperative shoulder function in patients with chronic rotator cuff tears.3.To study the affecting factors of outcomes after arthroscopic rotator cuff repair.Methods: From January 2017 to January2018,among 135 patients in our department who underwent arthroscopic rotator cuff repair of chronic rotator cuff tears,97 patients,47 males and 50 females were selected and included.Patients' pain and shoulder function were evaluated preoperatively.VAS score and Constant-Murley score were used to evaluate the preoperative situation of patients.The patient's MRI was improved and analyzed.Tendon injury was confirmed by intraoperative arthroscopic examination.All patients were followed up more than 1 year.VAS score and Constant-Murley score were used to evaluate the postoperative status of patients.SPSS20.0 was used for comparative statistical analysis of all data.Results: There were 97 subjects with an average followed-up time of15.28 ±7.42 months(12 ~ 24 months),the average preoperative VAS score was7.66 ±2.02(2 ~ 10 points)and the preoperative Constant-Murley score was51.14 ±8.34(34.5 ~ 66 points).The mean tear size was 14.88(+6.64 mm)(4.5-32 mm).The average fat infiltration was 1.43±0.95(grade 0 ~ 4),the average tendon retraction was 1.88±0.97(grade 1 ~ 4),and the average postoperative VAS score was 1.93±1.58(0 ~ 4points).the postoperative Constant-Murley score was performed with an average score of 79.06±7.75points(61 ~ 97 points).Mean VAS score before and after treatment was compared(7.66±2.02vs1.93±1.58),with statistical significance(P < 0.05);The mean Constant-Murley score before and after treatment was compared(51.14±8.34 points vs79.06±7.75 points),and the difference was statistically significant(P<0.05).The patients were divided into satisfactory group and unsatisfactory group according tothe postoperative Constant-Murley score ?80points and <80 points.55 cases were satisfied,and 42 cases were unsatisfied.There were no significant differences in age,sex,fat infiltration,onset time and tears grade between the two groups(P > 0.05).The preoperative VAS score was8.24±1.87 vs 6.90±1.96 point,the difference was statistically significant(P <0.05),and the comparative tear size was 11.94±5.76 vs 18.73 ±5.71 mm,the difference was statistically significant(P < 0.05).The postoperative VAS scores were 2.33±1.65 vs 1.40±1.35 points,and the preoperative Constant-Murley score was 48.89±8.12 vs 54.09±7.75 points,both of them with significant difference(P < 0.05).The correlation analysis showed that the preoperative VAS score was significantly correlated with the tear size(P<0.01).The preoperative VAS score was significantly correlated with the preoperativeshoulder Constant-Murley score(P<0.01).The preoperative VAS score was significantly correlated with the preoperative VAS score(P<0.01).The preoperative VAS score was significantly correlated with the postoperative shoulder Constant-Murley score(P<0.01).Multivariate analysis indicated that gender,tear size and preoperative VAS score had significant effects on postoperative VAS scores(P<0.05),and women's postoperative VAS scores were higher;tear size was negatively correlated with postoperative VAS scores;The preoperative VAS score was positively correlated with the postoperative VAS score.The tear size and the degree of tendon tears had a significant effect on the postoperative Constant-Murley score(P<0.05),and both had a negative correlation with the postoperative Constant--Murley score.Conclusion:Preoperative pain in patients with chronic rotator cuff is negatively correlated with the size of rotator cuff tear,positively correlated with preoperative function and postoperative pain.Preoperative pain in patients with chronic rotator cuff tears is an independent predictor of postoperative pain. |
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