Objective: To investigate the effect of asymptomatic hyperuricemia on the effectiveness of arthroscopic rotator cuff repair.
Methods: The clinical data of 80 patients who underwent arthroscopic rotator cuff repair and met the selection criteria between March 2018 and December 2019 were retrospectively analyzed. According to the serum uric acid level, the patients were divided into hyperuric acid group (46 cases, the serum uric acid level was more than 417 μmol/L in males and was more than 357 μmol/L in females) and normal group (34 cases, serum uric acid level was lower than the above standard). There was no significant difference in gender, age, side, body mass index, blood glucose level, total cholesterol level, rotator cuff tear size, and preoperative shoulder motion, visual analogue scale (VAS) score, University of California-Los Angeles (UCLA) score, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and other general data between the two groups ( P>0.05). The range of motion of abduction, forward flexion, and external rotation at 90° abduction were recorded and compared between the two groups before operation and at last follow-up; the improvement of shoulder pain was evaluated by VAS score; the improvement of shoulder function was evaluated by UCLA score, Constant score, and ASES score; and the shoulder joint MRI grade was evaluated according to Sugaya evaluation criteria.
Results: All patients were followed up 9-16 months, with an average of 11.9 months; there was no significant difference in the follow-up time between the two groups ( t=0.968, P=0.336). There were 2 cases of retear in the hyperuric acid group (including 1 case of severe tear) and 1 case of light retear in the normal group. The remaining patients in the two groups had no early-related complications. At last follow-up, the range of motion of the shoulder joints (abduction, forward flexion, external rotation at 90° abduction), VAS score, UCLA score, Constant score, and ASES score of the two groups were significantly improved when compared with preoperative ones ( P<0.05); the above indicators in the normal group were significantly better than those in the hyperuric acid group ( P<0.05). The MRI grade of the shoulder joint in the normal group was significantly better than that in the hyperuric acid group ( Z=-2.000, P=0.045).
Conclusion: Compared with patients with normal serum uric acid level, asymptomatic hyperuricemia can lead to worse recovery after arthroscopic rotator cuff repair in patients with rotator cuff tears.
目的: 探讨无症状高尿酸血症对关节镜肩袖修补术后临床效果的影响。.
方法: 回顾性分析 2018 年 3 月—2019 年 12 月行关节镜肩袖修补术且符合选择标准的 80 例患者临床资料，根据血尿酸水平分为高尿酸组（46 例，男性>417 μmol/L，女性>357 μmol/L）和正常组（34 例，血尿酸水平低于上述标准）。两组患者性别、年龄、侧别、体质量指数、血糖水平、总胆固醇水平、肩袖撕裂大小及术前肩关节活动度、疼痛视觉模拟评分（VAS）、美国加州大学洛杉矶分校（UCLA）评分、Constant 评分、美国肩肘外科协会（ASES）评分等一般资料比较差异均无统计学意义（ P>0.05）。记录并比较两组患者术前及末次随访时肩关节中立位外展、前屈、外展 90° 外旋活动度；采用 VAS 评分评价肩关节疼痛改善情况；采用 UCLA 评分、Constant 评分及 ASES 评分评价肩关节功能改善情况，参照 Sugaya 评价标准行肩关节 MRI 分级评价。.
结果: 患者均获随访，随访时间 9～16 个月，平均 11.9 个月；两组随访时间差异无统计学意义（ t=0.968， P=0.336）。高尿酸组发生再撕裂 2 例（其中 1 例为重度撕裂），正常组发生轻度再撕裂 1 例；两组其余患者无早期手术相关并发症发生。末次随访时，两组患者肩关节活动度（外展、前屈、外展 90° 外旋）、VAS 评分、UCLA 评分、Constant 评分及 ASES 评分均较术前显著改善（ P<0.05）；正常组上述指标均显著优于高尿酸组（ P<0.05）。正常组肩关节 MRI 分级优于高尿酸组，差异有统计学意义（ Z=–2.000， P=0.045）。.
结论: 与正常血尿酸水平患者相比，无症状高尿酸血症会导致肩袖撕裂患者行关节镜肩袖修补术后恢复效果更差。.
Keywords: Rotator cuff tear; clinical prognosis; rotator cuff repair; serum uric acid.