Tendon stump change as a risk factor for structural failure of arthroscopic rotator cuff repair

Q2 Medicine

JSES International Pub Date : 2025-07-01 DOI:10.1016/j.jseint.2025.02.011

Jun Kawamata MD , Shoji Fukuta MD, PhD , Masashi Kano MD , Kohei Yoshikawa MD , Koichi Sairyo MD, PhD

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Abstract

Background

This study aimed to identify risk factors for retear after arthroscopic rotator cuff repair (ARCR) using the suture bridge method and to assess the relation between preoperative and postoperative tendon condition and retear.

Methods

We retrospectively analyzed patients who underwent ARCR for a medium tear. Potential risk factors, including tear width, anteroposterior and medial-lateral tear width, atrophy, fatty degeneration, and condition of the tendon stump (Ishitani's classification and rotator cuff/deltoid muscle [C/D] ratio), were identified on magnetic resonance preoperatively. Magnetic resonance imaging was performed regularly after surgery, and the C/D ratio in the sutured cuff was evaluated. Shoulders that were Sugaya type I-III were classified as the repair group and those that were type IV or V as the retear group. Risk factors for retear were analyzed by univariable and multivariable analyses.

Results

We analyzed 175 patients in 183 shoulders. The overall retear rate was 13.1%. Multivariable analysis revealed medial-lateral width (odds ratio: 0.88; 95% confidence interval: 0.82-0.95; P < .001) and C/D ratio (odds ratio: 0.30; 95% confidence interval: 0.16-0.58; P < .001) as independent risk factors for retear. At 3 weeks postoperatively, the C/D ratio was significantly higher in the retear group (1.70 ± 1.47 vs. 0.84 ± 0.72; P = .002).

Conclusions

The C/D ratio and tear width were risk factors for retear after ARCR using the suture bridge method. The C/D ratio was higher in retear cases both preoperatively and postoperatively.

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肌腱残端改变是关节镜下肩袖修复术后结构失效的危险因素

本研究旨在确定关节镜下肩袖修复术（ARCR）后肌腱再撕裂的危险因素，并评估术前和术后肌腱状况与肌腱再撕裂的关系。方法回顾性分析中等撕裂行ARCR的患者。术前通过磁共振确定潜在危险因素，包括撕裂宽度、前后外侧撕裂宽度、萎缩、脂肪变性和肌腱残端状况（Ishitani分类和肩袖/三角肌[C/D]比值）。术后定期行磁共振成像，评估缝合袖带的C/D比值。Sugaya I-III型肩胛骨为修复组，IV型或V型肩胛骨为修复组。采用单变量和多变量分析方法分析复发的危险因素。结果我们分析了175例患者183个肩部。总回收率为13.1%。多变量分析显示内侧外侧宽度(优势比：0.88；95%置信区间：0.82-0.95；P & lt;.001)和C/D比(优势比：0.30；95%置信区间：0.16-0.58；P & lt;.001)作为复发的独立危险因素。术后3周，retear组C/D比值明显高于对照组(1.70±1.47∶0.84±0.72；P = .002)。结论C/D比值和撕裂宽度是采用缝合桥法进行ARCR术后再撕裂的危险因素。术前和术后复发病例的C/D比均较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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