| Objective: This study aimed to investigate the short-term clinical effect of radial extracorporeal shockwave therapy(ESWT)on patients after arthroscopic rotator cuff repair.Methods: According to the inclusion and exclusion criteria,38 patients who underwent arthroscopic rotator cuff repair in the Department of Sports Medicine of Huashan Hospital from July 2019 to June 2020 were selected as the research objects.At 3 months postoperatively,the subjects were randomly divided into the ESWT group(n=19)and the regular exercise group(n=19).All participants received 5 weeks of regular exercise.And the ESWT group,based on regular exercise,combined with shockwave therapy once a week for 5 weeks.VAS score,Constant score,UCLA score,ASES score,FUSS score and active range of motion were used to evaluate the pain relief and functional recovery of patients at 3 months,5 months and 6 months follow-up.MRI was performed at 3 months and 6 months postoperatively to evaluate the tendon healing,muscle atrophy and fatty infiltration.Results: A total of 38 patients after arthroscopic rotator cuff repair were included in this study.During the study period,6 patients were excluded due to the influence of COVID-19.1 person in the ESWT group was unable to participate in the second MRI examination because of an ankle sprain.In the end,a total of 32 patients(16 in each group)completed the follow-up,and 31 patients(ESWT group,n=15;regular exercise group,n=16)obtained complete MRI data.1.Clinical efficacy:At 5 and 6 months after surgery,the VAS scores in both groups were significantly lower than 3 months post-surgery(P<0.001).Compared with the regular exercise group,the decrease was more significant than the ESWT group(P<0.05).Functional scores including CMS,UCLA,ASES,FUSS was significantly improved in both groups at 5and 6 months follow-up,which were significantly better than 3 months(P<0.001).In terms of ASES,the improvement in the ESWT group was more obvious than that in the regular exercise group(P< 0.05),while there were no significant differences in other functional scores(CMS,UCLA,FUSS)among the groups(P > 0.05).At 5 and 6months follow-up,the active range of motion(including flexion,abduction,external rotation,internal rotation)in both groups increased significantly compared with 3months postoperatively(P<0.001),while no significant difference between the ESWT and regular exercise group(P>0.05).2.MRI findings:In terms of Sugaya classification,both groups were predominantly Type II and III at 3months postoperatively,Type I,II,and III were the main types at 6 months postoperatively.At 6 months post-surgery,the Sugaya classification of the two groups was significantly improved compared with 3 months(P<0.05),but there was no significant difference between the groups(P>0.05).At 6 months follow-up,the average SNQ in the ESWT group showed a downward trend compared with 3 months,but it was not significant(P<0.05);there was no significant change in the regular exercise group(P<0.05).Further analysis found that the SNQ at the proximal area in the ESWT group was significantly lower than that of 3 months(P<0.05)and was significantly lower than that of the regular exercise group(P<0.05).However,in the regular exercise group,no significant change was found at the proximal area SNQ between 3 and 6months after surgery(P>0.05).At 6 months postoperative,the middle and distal SNQ of the ESWT group were not significantly different from those of 3 months(P>0.05),nor were they significantly different from those of the regular exercise group(P>0.05).At 3 months and 6 months after surgery,the patients in both groups were mainly of type I and II in Thomazeam and Goutallier classification,and there was no significant difference between the two groups before and after the intervention(P>0.05),nor between the ESWT group and the regular exercise group(P>0.05).Conclusion: ESWT can alleviate shoulder pain and improve the signal/noise quotient of proximal supraspinatus tendon 6 months after rotator cuff repair. |
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