Background:Despite advancements in surgical technique, failure of tendon healing remains a common problem after arthroscopic rotator cuff repair (ARCR).Purpose/Hypothesis:The purpose of this study was to examine the relationship between range of motion (ROM) recovery and healing after ARCR. It was hypothesized that an early loss of ROM would be associated with tendon healing.Study design:Case-control study; Level of evidence, 3.Methods:This was a retrospective comparative study of primary ARCR of isolated full-thickness supraspinatus (SSN) tendon tears. Cases were retrieved from a prospective rotator cuff repair database and divided into 2 groups based on healing (healed/nonhealed). A standardized clinical evaluation was performed before and at 6 weeks, 3 months, and 6 months after surgery. Collected data included passive and active ROM, visual analog scale for pain, and Constant score. Healing was assessed by ultrasound at 6 months.Results:Of 1397 eligible ARCRs, 1207 were included. The healing rate was 86.7%. Age was higher in the nonhealed group (57.8 ± 7.9 years vs 61.6 ± 8.8 years; P < .001). Patients with healed repairs had a larger decrease in passive anterior elevation (AE) from the preoperative to the 6-week postoperative visit (–31°± 28° vs −18°± 26°; P < .001), followed by a more substantial increase throughout the remaining follow-up period (32°± 23° vs 18°± 21°; P < .001). At 6 months postoperatively, there was no difference in AE between groups (159°± 17° vs 161°± 14°; P > .999). External rotation elbow at side (ER1) and internal rotation hand in the back (IR1) followed similar courses of recovery. Passive and active ROM had a strong positive correlation at each follow-up. Age (odds ratio [OR], 1.79; 95% CI, 1.45-2.23; P < .001) and 6-week passive AE (OR, 1.33; 95% CI, 1.20-1.48; P < .001) and ER1 (OR, 1.15; 95% CI, 1.03-1.29; P = .017) were predictors for nonhealing.Conclusion:Lower passive AE and ER1 at 6 weeks postoperatively and younger age are associated with healing after ARCR of isolated SSN tendon tears. At 6 months postoperatively, there were no differences in ROM, regardless of tendon healing.

中文翻译：

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术后 6 周的下被动前抬高和外旋是否与孤立关节镜冈上肌修复术的愈合相关？

背景：尽管手术技术取得了进步，但肌腱愈合失败仍然是关节镜下肩袖修复（ARCR）后的一个常见问题。目的/假设：本研究的目的是检查术后关节活动度（ROM）恢复与愈合之间的关系。 ARCR。据推测，ROM 的早期丧失与肌腱愈合有关。研究设计：病例对照研究；证据级别，3。方法：这是对孤立的全层冈上肌 (SSN) 肌腱撕裂的原发 ARCR 的回顾性比较研究。从前瞻性肩袖修复数据库中检索病例，并根据愈合情况分为 2 组（愈合/未愈合）。术前和术后 6 周、3 个月和 6 个月进行标准化临床评估。收集的数据包括被动和主动 ROM、疼痛视觉模拟量表和恒定评分。 6 个月时通过超声评估愈合情况。结果：在 1397 名符合条件的 ARCR 中，纳入了 1207 名。治愈率为86.7%。未愈合组的年龄较高（57.8 ± 7.9 岁 vs 61.6 ± 8.8 岁；P < .001）。从术前到术后 6 周就诊，修复愈合的患者被动前抬高 (AE) 下降幅度更大（–31°± 28° 对比 -18°± 26°；P < .001），随后出现更多的被动前抬高 (AE) 下降。在剩余的随访期内显着增加（32°± 23° vs 18°± 21°；P < .001）。术后 6 个月，组间 AE 没有差异（159°± 17° vs 161°± 14°；P > .999）。侧面外旋肘 (ER1) 和背部内旋手 (IR1) 遵循类似的恢复过程。每次随访时，被动和主动 ROM 均呈很强的正相关。年龄（优势比 [OR]，1.79；95% CI，1.45-2.23；P < .001）和 6 周被动 AE（OR，1.33；95% CI，1.20-1.48；P < .001）和 ER1（ OR，1.15；95% CI，1.03-1.29；P = 0.017）是不愈合的预测因子。结论：术后 6 周较低的被动 AE 和 ER1 以及较小的年龄与孤立性 SSN 肌腱撕裂 ARCR 后的愈合相关。术后 6 个月时，无论肌腱愈合情况如何，ROM 都没有差异。