糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复影响的临床研究

Effect of Diabetes Mellitus on Functional Recovery of Shoulder Joint after Arthroscopic Rotator Cuff Repair

目的探讨糖尿病对关节镜下肩袖修复术后病人肩关节功能恢复的影响。方法回顾性分析我科自2019年5月至2022年5月接受关节镜下肩袖修复术的62例肩袖损伤病人的临床资料和随访结果,其中糖尿病组30例,男18例,女12例,年龄为(62.10±11.87)岁;对照组32例,男18例,女14例,年龄为(63.78±12.98)岁。手术方式均为关节镜下缝线桥技术缝合肩袖。分别记录两组病人术前1周、术后3个月、6个月和12个月各时间点肩关节最大外展角度值,以及肩关节功能评分,包括疼痛视觉模拟量表(visual analogue scale,VAS)评分、美国肩肘外科协会(American Shoulder Elbow Surgeon,ASES)评分、加州大学洛杉矶分校(University of California at Los Angeles,UCLA)肩关节评分以及Constant⁃Murley评分。据此对手术效果进行评估。结果62例病人均未出现伤口感染、术后僵硬、术后再撕裂等并发症。两组病人的肩关节最大外展角度值、VAS评分、ASES评分、UCLA评分以及Constant⁃Murley评分均在术后3个月、6个月和1年得到显著改善(P<0.05)。糖尿病组的肩关节最大外展角度值及各肩关节功能评分在术前1周、术后3个月及6个月时均劣于对照组(P<0.05),但在术后12个月时,糖尿病组与对照组比较,差异无统计学意义(P>0.05)。结论糖尿病对关节镜下肩袖修复术后的病人短期恢复会存在影响,但长期临床结果没有显著差异。围手术期血糖控制良好的糖尿病病人在关节镜下肩袖修复术后表现出与非糖尿病病人相当的临床和结构恢复。

Objective To investigate the influence of diabetes mellitus on the recovery of shoulder joint function after arthroscopic rotator cuff repair.Methods The clinical data and follow⁃up results of 62 patients with rotator cuff injury who underwent arthroscopic rotator cuff repair from May 2019 to May 2022 were retrospectively analyzed.There were 30 cases in the diabetic group,including 18 males and 12 females,aged(62.10±11.87)years,and 32 cases in the control group,including 18 males and 14 females,aged(63.87±12.98)years.The rotator cuff was sutured by arthroscopic suture⁃bridge technology.The maximum abduction angle of the shoulder joint and the shoulder joint function score,including the visual analogue scores(VAS),American shoulder elbow surgeon score(ASES),University of California at Los Angeles(UCLA)shoulder scores and Constant⁃Murley shoulder function score,were recorded at 1st week before operation,and 3rd,6th and 12th month after operation.The effect of the operation was evaluated based on the results.Results None of the 62 patients had complications such as wound infection,postoperative stiffness,and postoperative re⁃tearing.The maximum abduction angle of the shoulder joint,VAS score,ASES score,UCLA score and Constant⁃Murley score were significantly improved in both groups at 3rd month,6th month and 1st year after operation(P<0.05).The maximum abduction angle of the shoulder joint and the scores of shoulder joint function in the diabetic group were worse than those in the control group at 1st week before operation,3rd month and 6th month after operation(P<0.05),but there was no significant difference between the diabetic group and the control group at 12th month after operation(P>0.05).Conclusion Diabetes affects short⁃term recovery after arthroscopic rotator cuff repair,but there is no significant difference in long⁃term clinical outcomes.Diabetic patients with good perioperative glycemic control show comparable clinical and structural recovery to non⁃diabetic patients after arthroscopic rotator cuff repair.