Study On The Effect Of Hyperuricemia On The Efficacy Of Rotator Cuff Repai

Objective: To analyze the correlation between serum uric acid and postoperative efficacy of rotator cuff repair.Methods: A retrospective case-control study was conducted in 145 patients with rotator cuff injury undergoing arthroscopic repair of rotator cuff injury in the affiliated Hospital of Qingdao University.General factors of patients were collected: age,gender,side profile,body mass index,symptom duration,tear type,fat infiltration,history of smoking(>1 year),history of diabetes(>1 year),preoperative abduction,preoperative flexion,preoperative abduction 90° external rotation,preoperative VAS score,preoperative Constant score,preoperative MRI Sugaya grade.Main study factors: preoperative serum uric acid level,history of hyperuricemia(>1 year),history of gout(>1 year)combined with drug therapy.Postoperative time was 1 year.Postoperative indicators were observed: shoulder function(Constant score)(primary outcome variable),range of motion(abduction,flexion,abduction 90° external rotation)(secondary outcome variable),pain(VAS score)(secondary outcome variable)and retear evaluation(MRI Sugaya grading of shoulder)(secondary outcome variable).According to the Constant score standard of postoperative shoulder joint function,<80 were divided into the case group(dissatisfied group).≥80 were divided into control group(satisfied group).Firstly paired samples t test was used for all of the patients after preoperative curative effect analysis,univariate analysis was used for the factors between the two groups,correlation analysis mainly studies the relationship between the major factors,stepwise Logistic regression analysis was used for the independent risk factors between the two groups,correlation analysis was used between the two groups of the primary and the secondary outcome,multiple regression analysis was performed on the influencing factors of secondary outcome variables.Results: The range of motion,VAS score,Constant score and MRI Sugaya grading of shoulder were significantly improved in all patients after surgery(P<0.05).Univariate analysis showed that there were statistically significant differences in age,smoking history,hyperuric acid history(>1 year),preoperative uric acid level,symptom duration and preoperative VAS score between the two groups(P<0.05).Correlation analysis results of major study factors showed that preoperative serum uric acid level,history of hyperuricemia(>1 year)and history of gout(>1 year)were significantly correlated(P<0.05).Step-up Logistic regression analysis showed that higher preoperative uric acid level,longer symptom duration and higher preoperative VAS score were independent risk factors leading to patient dissatisfaction(P<0.05).The correlation analysis between primary outcome variables and secondary outcome variables showed that postoperative Constant score was significantly correlated with postoperative abduction,postoperative flexion,postoperative abduction 90° external rotation and postoperative VSA score(P<0.05).Multiple regression analysis of secondary outcome variables showed that side type,hyperuricemia history,preoperative uric acid level and symptom duration were the factors affecting postoperative abduction activity.Preoperative uric acid level and symptom duration were the factors influencing postoperative flexion activity.Gender,age and preoperative VAS score were the factors that affected the 90° external rotation activity of postoperative abduction.Factors affecting VAS score were smoking history and preoperative uric acid level.Factors affecting postoperative MRI Sugaya grading was preoperative blood uric acid level.Conclusion: There is a certain correlation between the high preoperative uric acid level and the history of hyperuricemia and the unsatisfactory postoperative efficacy of patients.Objective: To analyze the effect of hyperuricemia on tendon-bone healing of rotator cuff injury in rats.Methods: 30 rats were randomly divided into two groups,15 rats in normal uric acid group were given sodium carboxymethyl cellulose intragastric administration daily,namely the control group.15 rats in hyperuric acid group were given sodium carboxymethyl cellulose potassium oxyazinate intragastric administration daily,namely the experimental group.Serum uric acid,serum creatinine and blood urea nitrogen levels of rats in both groups were measured and recorded at the same time every week.Supraspinatus tendon was injured in both groups at the 4th week,and tendon-bone were sutured by bone tunnel suture.The rats in the two groups were fed intragastric in the original way and tested regularly.At the8 th week,the rats were sacrificed and the humeral head-supraspinatus-scapula specimens were collected for gross observation of the two groups of specimens,histological HE staining analysis,biomechanical analysis and detection of ELISA inflammatory factors IL-1,IL-6,IL-1b and TNF-a.Results: The visual observation results of the two groups of specimens showed that the experimental group had obvious bleeding and poor scar adhesion.The results of HE staining showed that the healing level of tendon-bone in the control group was clear,a few chondrocytes were generated,and the collagenous fibers were arranged in an orderly manner.In the experimental group,the tendon-bone interface was not clear,and the collagen fibers were arranged loosely and disordered,and fat vacuoles were occasionally seen.The results of biomechanical analysis showed that the maximum load in high uric acid group was lower than that in normal control group 4 weeks after operation(P < 0.05).There was no significant difference in stiffness between the two groups(P>0.05).ELISA inflammatory factor analysis showed that the concentrations of IL-1,IL-6 and IL-1b in the experimental group were significantly higher than those in the control group(P<0.05).There was no significant difference in TNF-a concentration between the two groups(P>0.05).Conclusion: Persistent hyperuricemia is not conducive to tendon-bone healing after rotator cuff injury in rats.