术前长期服用非甾体抗炎药不会影响肩袖、跟腱、肱二头肌远端或股四头肌腱修复术后的翻修率

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-04-01 DOI:10.1016/j.asmr.2024.101034

Romir Parmar B.S. , Sailesh V. Tummala M.D. , Alejandro Holle B.S. , Jose Iturregui M.D. , Alexander J. Hoffer M.D. , John M. Tokish M.D.

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引用次数: 0

摘要

目的确定术前长期使用非甾体抗炎药（NSAID）是否影响以下常见运动医学外科手术：肩袖修复（RCR）、跟腱修复（ATR）、远端肱二头肌修复（DBR）或股四头肌肌腱修复（QTR）的初级肌腱修复后翻修率。方法采用国家保险数据库进行回顾性比较研究。接受大肌腱修复的患者，包括RCR、ATR、DBR或QTR，随访至少2年。根据年龄、性别、特定肌腱修复情况和Elixhauser合并症指数，确定在指数手术前诊断长期使用非甾体抗炎药的患者，并将其与未使用非甾体抗炎药的对照组进行1:4匹配。比较两组的修复率。结果36068例患者行大肌腱修复术。其中，7,246人（20%）在肌腱修复前符合长期使用非甾体抗炎药的标准（非甾体抗炎药使用者）。RCR后，3.2%的非甾体抗炎药使用者（n = 190）和2.6%的对照组（n = 617）在2年内接受了翻修手术(优势比[OR]， 1.15；95%置信区间[CI]， 0.97-1.36；P = .10)。ATR后，非甾体抗炎药使用者的修订率为3.9% (n = 24)，对照组为2.5% (n = 62) (OR, 1.47；95% ci, 0.89-2.38；P = .12)。DBR后，非甾体抗炎药使用者和对照组的翻修病例均少于11例(OR, 1.54；95% ci, 0.49-4.16；P = .42)。QTR后，非甾体抗炎药使用者的修正率为5.9% (n = 30)，而对照组的修正率为4.8% (n = 95) (OR, 1.22；95% ci, 0.77-1.86；P = .38)。在非甾体抗炎药使用者和对照组之间，未观察到修改率有显著差异。结论：诊断和编码术前长期使用非甾体抗炎药的患者在2年内进行初级肌腱修复的翻修率并不比未诊断的患者高。证据等级：III级，回顾性病例对照研究。

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Long-Term Preoperative Nonsteroidal Anti-inflammatory Drug Use Does Not Impact Revision Rate After Repair of Rotator Cuff, Achilles, Distal Biceps, or Quadriceps Tendon

Purpose

To determine whether long-term preoperative nonsteroidal anti-inflammatory drug (NSAID) use affected the revision rates after primary tendon repair for the following common sports medicine surgical procedures: rotator cuff repair (RCR), Achilles tendon repair (ATR), distal biceps repair (DBR), or quadriceps tendon repair (QTR).

Methods

A retrospective comparative study using a national insurance database was performed. Patients who underwent major tendon repair, including RCR, ATR, DBR, or QTR, with at least 2-year follow-up were identified. Those who had a diagnosis of long-term NSAID use prior to the index operation were identified and matched 1:4 to controls without NSAID use based on age, sex, specific tendon repaired, and Elixhauser Comorbidity Index. The revision repair rates of the 2 groups were compared.

Results

A total of 36,068 patients underwent major tendon repair. Of these, 7,246 (20%) met the long-term NSAID use criteria prior to tendon repair (NSAID users). After RCR, 3.2% of NSAID users (n = 190) and 2.6% of controls (n = 617) underwent revision surgery within 2 years (odds ratio [OR], 1.15; 95% confidence interval [CI], 0.97-1.36; P = .10). After ATR, NSAID users had a revision rate of 3.9% (n = 24) versus 2.5% (n = 62) in the control cohort (OR, 1.47; 95% CI, 0.89-2.38; P = .12). After DBR, both NSAID users and controls had fewer than 11 revision cases (OR, 1.54; 95% CI, 0.49-4.16; P = .42). After QTR, the revision rate was 5.9% (n = 30) for NSAID users compared with 4.8% (n = 95) for the control group (OR, 1.22; 95% CI, 0.77-1.86; P = .38). None of the observed differences in revision rates between NSAID users and controls were significant.

Conclusions

Patients with a diagnosis of and coding for long-term preoperative NSAID use do not have greater revision rates within 2 years of primary tendon repair than patients without this diagnosis.