부산대학교 도서관

Introduction and Background The purpose of this study was to evaluate the clinical characteristics of patients with symptomatic failed rotator cuff repair who required revision surgeries and to identify clinical and radiological factors related to the need for revision surgery. Material and Method Ninety-eight patients who were diagnosed with rotator cuff retear within 2 years after primary arthroscopic surgery were included. Patients were divided into two groups: patients who underwent revision surgery within 2 years postoperatively (44 patients, group I) and patients who did not require additional treatment due to minimal discomfort during the same period (54 patients, group II). Demographic and radiographic factors related to cuff healing were analyzed. Univariate and multivariate analyses were performed to evaluate factors related to revision surgery. Results Group I showed significantly inferior clinical outcomes at the time of revision compared to group II (ASES; 54.0±12.1 vs. 86.5±12.2, Constant; 65.2±10.8 vs. 84.0±11.4, P<0.001). Total cholesterol level (210.2±40.0 vs. 189.7±39.1, P=0.012), LDL level (130.7±28.7 vs. 115.5±26.9, P=0.008), and fatty infiltration of the infraspinatus (20.5% vs. 3.7%, P=0.011) were significantly higher in group I than in group II. In postoperative MRI, retear of the infraspinatus tendon occurred significantly more frequently in group I (81.8%) than in group II (37.0%, P<0.001). In group I, relative changes in anteroposterior (AP) (19.2±37.8) and mediolateral (ML) retear size (29.6±90.7) were significantly greater than in group II (AP; -39.5±19.2, ML; -29.2±26.8, P<0.001). Relative change in AP retear size was the most powerful independent predictor of symptomatic failed rotator cuff repair (OR; 1.19, CI; 1.08-1.31, P<0.001). Conclusions Preoperative serum total cholesterol level, LDL level, and fatty infiltration of the infraspinatus were significantly related to symptomatic failed rotator cuff repair. Relative change in AP retear size was the most powerful independent predictor of symptomatic failed rotator cuff repair.