To Predict The Influencing Factors Of The Postoperative Effect Of Arthroscopic Rotator Cuff Repair And Construct A Nomogram

Objective:To explore the factors influencing the postoperative outcome of arthroscopic single-row rivet rotator cuff repair in patients with rotator cuff injury and to construct the related nomogram risk prediction model.Methods:From January 2016 to August 2016,207 patients with rotator cuff injury underwent arthroscopic single-row rivet rotator cuff 2021.And all the data were analyzed statistically,according to the results of multi-factor logistic regression analysis to build the relevant nomogram model,the accuracy,discrimination and clinical value of the predictive model were evaluated by calibration chart,AUC,C-index and decision curve analysis.At last,we use self-random sampling for internal verification.Results:The mean follow-up time was 29.92 ± 17.20 months.All 207 patients,including 42 elderly patients ≥65 years old,had significant difference in VAS score and UCLA score before operation compared with those at last follow-up(p < 0.05)Multivariate regression analysis showed: combined frozen shoulder(OR=3.890,95%CI :1.544～9.800),massive rotator cuff tear(OR=3.809,95%CI:1.218～11.908),rivet number(OR=2.118,95%CI:1.386～3.237),preoperative UCLA score(OR=0.831,95%CI:0.704～0.981)was the most important factor influencing the outcome of arthroscopic single-row rivet rotator cuff repair for rotator cuff injury.Predictive factors included in the nomogram included combined frozen shoulder,massive rotator cuff tear,number of rivets,and preoperative UCLA score.The model showed good discriminant and predictive power,with an AUC of 0.849 and a C-index of 0.900(95%CI : 0.845～0.955),and a corrected C-index of 0.836 in internal validation.The decision curve analysis also showed that the nomogram could be used clinically when the intervention was performed at a threshold of 2% to 91%.Conclusions:Arthroscopic single-row rivet rotator cuff repair resulted in significant improvement in shoulder pain and function,including in the elderly population ≥65 years of age.Combined frozen shoulder,massive rotator cuff tear,and increased number of intraoperative rivets all increased the risk of poor outcomes after arthroscopic rotator cuff repair,while higher preoperative UCLA scores reduced the risk of poor outcomes after arthroscopic rotator cuff repair.This study provides clinicians with a new and relatively high accuracy nomogram model to accurately assess the risk of poor postoperative outcome in patients with rotator cuff injury requiring arthroscopic rotator cuff repair at the beginning of treatment.By estimating the individual risk,clinicians can proactively take more favorable interventions before,during,and after arthroscopic rotator cuff repair.