Clinical Efficacy Analysis Of Early Versus Delayed Repair Of Traumatic Rotator Cuff Injuries

Background:With the increase in the proportion of elderly people and the development of fitness science,the number of patients with rotator cuff injuries caused by degeneration,sports injuries and trauma is on the rise.Rotator cuff injuries are a common clinical condition of the shoulder joint,and the quality of life of patients is severely affected by shoulder pain and limitation of motion.The vast majority of rotator cuff injuries are chronic injuries caused by degenerative disease,while traumatic rotator cuff injuries occur in patients who have had no shoulder symptoms.Patients tend to have sudden onset shoulder pain,reduced shoulder strength,and limited movement due to trauma.In recent years,with the continuous research on rotator cuff injuries and the development of shoulder joint treatment techniques,arthroscopic repair of rotator cuff injuries has increased.Traumatic events often lead to traumatic rotator cuff injuries,and this diagnosis is often missed and treatment delayed at the patient’s first visit.The optimal timing of treatment for traumatic rotator cuff injuries is inconclusive,current practice varies widely,and few studies have been reported on the timing and clinical outcomes of surgery for traumatic rotator cuff injuries.The clinical efficacy of early versus delayed repair of traumatic rotator cuff injuries warrants further study and analysis.Objective:The purpose of this study was to compare the postoperative clinical efficacy in patients with early repair(≤3 months)versus delayed repair(>3 months)of traumatic rotator cuff injuries and to investigate whether the timing of surgery has an impact on the prognosis of patients.Methods:To perform an exclusionary screening of rotator cuff injury cases admitted to the Department of Orthopaedic and Sports Medicine of Qingdao Municipal Hospital from June 2021 to June 2022.42 of 118 patients met the criteria for inclusion in the study,72 were excluded because of no obvious history of trauma or combined other tendon injuries,and 4 were excluded because of contraindications to surgery.This is a retrospective study,and the included cases were divided into an early repair group(24cases)and a delayed repair group(18 cases).Basic information of all patients included in the study,and the preoperative,6 weeks postoperative,12 weeks postoperative,and 24 weeks postoperative Visual Analogue Scale(VAS),University of California at Los Angeles(UCLA)shoulder score,American Shoulder and Elbow Surgeons Scale(ASES),Constant-Murely(CM)shoulder joint function score.All patients underwent arthroscopic rotator cuff suturing,and all were sutured with threaded rivets during the procedure.All patients were injected with 2 sodium hyaluronate injection into the shoulder cavity before suturing the surgical incision,and all patients wore a shoulder abduction brace immediately after surgery.Descriptive statistics were used to summarize the patients’ baseline data;continuous count variables that conformed to a normal distribution were analyzed by t-test or ANOVA,variables that were not normally distributed were analyzed using the Mann-Whitney U nonparametric rank sum test,the chi-square test or Fisher’s test is used to analyze categorical variables.All analyses were performed using SPSS 26.0,and P < 0.05 was considered statistically different and P < 0.001 was considered statistically significantly different.Results:21 patients in the early repair group were followed up,with a follow-up rate of 87.5%,and 17 patients in the delayed repair group were followed up,with a follow-up rate of94.4%.Statistically analyzed: There was no statistical difference(P > 0.05)in VAS score,UCLA score,and ASES score between the early repair group and the delayed repair group before surgery,6 weeks after surgery,and 12 weeks after surgery respectively,and there was a statistical difference(P < 0.05)in VAS score,UCLA score and ASES score between the two groups at 24 weeks after surgery.The VAS score,UCLA score,and ASES score in the early repair group were better than the delayed repair group.However,there was no significant difference(P > 0.05)between the CM scores of the early repair group and the delayed repair group at all stages preoperatively and postoperatively.The overall results showed that the clinical efficacy of the early repair group was better than that of the delayed repair group.Conclusion:Early repair of traumatic rotator cuff injuries has more significant clinical outcomes than delayed repair.Early repair(≤3 months)is recommended for traumatic rotator cuff injuries.Early repair of traumatic rotator cuff injuries is superior to delayed repair in terms of both pain relief and improvement in shoulder function and motion.