Katsutoshi Miyatake1, Yoshitsugu Takeda2, Koji Fujii3, Naoto Suzue3, Yoshiteru Kawasaki3, Yasuyuki Omichi3, Kenji Yokoyama3. 1. Department of Orthopaedic Surgery, Yoshinogawa Medical Center, 120 Nishichiejima, Chiejima, Kamojima-cho, Yoshinogawa, Tokushima, 776-8511, Japan. 2. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, 103 Irinokuchi, Komatsushima-cho, Komatsushima, Tokushima, 773-8502, Japan. ytakeda@tokushima-med.jrc.or.jp. 3. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, 103 Irinokuchi, Komatsushima-cho, Komatsushima, Tokushima, 773-8502, Japan.
Abstract
PURPOSE: To compare clinical outcome and rotator cuff integrity after arthroscopic rotator cuff repair (ARCR) in patients with and without diabetes mellitus. METHODS: This retrospective study involved 264 consecutive patients who underwent ARCR from 2012 to 2015. Inclusion criteria were a medium or large-sized tear and a minimum of 1-year follow-up. Clinical outcome measures included range of motion (ROM) and the Japanese Orthopaedic Association (JOA) and University of California, Los Angeles (UCLA) scores preoperatively and at final follow-up. Rotator cuff retear was evaluated with magnetic resonance imaging at 3 months post-surgery and final follow-up. Diabetic patients with poor control were pre-operatively hospitalized for intensive diabetic control. RESULTS: Our inclusion criteria were met by 30 diabetic patients and 126 non-diabetic patients. Demographic data were not significantly different between the groups, except body mass index (p = 0.021). Preoperative JOA and UCLA scores of the diabetic patients were significantly lower than those of the non-diabetic patients (p < 0.001, and p = 0.006, respectively); however, the scores at final follow-up were not different. ROM was significantly restricted in the diabetic patients before surgery (forward flexion, abduction, internal rotation: p < 0.001, external rotation: p = 0.035), but at the final follow-up, there was no significant difference except for internal rotation (p = 0.005). The retear rate in diabetic patients (23.3%) was not significantly different from that in non-diabetic patients (15.1%). CONCLUSIONS: Diabetic patients who had good perioperative glycemic control showed clinical and structural outcomes comparable to non-diabetic patients after ARCR. Intensive perioperative glycemic control and patient education are recommended for preoperative uncontrolled diabetic patients. LEVEL OF EVIDENCE: III.
PURPOSE: To compare clinical outcome and rotator cuff integrity after arthroscopic rotator cuff repair (ARCR) in patients with and without diabetes mellitus. METHODS: This retrospective study involved 264 consecutive patients who underwent ARCR from 2012 to 2015. Inclusion criteria were a medium or large-sized tear and a minimum of 1-year follow-up. Clinical outcome measures included range of motion (ROM) and the Japanese Orthopaedic Association (JOA) and University of California, Los Angeles (UCLA) scores preoperatively and at final follow-up. Rotator cuff retear was evaluated with magnetic resonance imaging at 3 months post-surgery and final follow-up. Diabeticpatients with poor control were pre-operatively hospitalized for intensive diabetic control. RESULTS: Our inclusion criteria were met by 30 diabeticpatients and 126 non-diabeticpatients. Demographic data were not significantly different between the groups, except body mass index (p = 0.021). Preoperative JOA and UCLA scores of the diabeticpatients were significantly lower than those of the non-diabeticpatients (p < 0.001, and p = 0.006, respectively); however, the scores at final follow-up were not different. ROM was significantly restricted in the diabeticpatients before surgery (forward flexion, abduction, internal rotation: p < 0.001, external rotation: p = 0.035), but at the final follow-up, there was no significant difference except for internal rotation (p = 0.005). The retear rate in diabeticpatients (23.3%) was not significantly different from that in non-diabeticpatients (15.1%). CONCLUSIONS:Diabeticpatients who had good perioperative glycemic control showed clinical and structural outcomes comparable to non-diabeticpatients after ARCR. Intensive perioperative glycemic control and patient education are recommended for preoperative uncontrolled diabeticpatients. LEVEL OF EVIDENCE: III.
Authors: Ken Lee Puah; Muhammad Sabith Salieh; William Yeo; Andrew Hwee Chye Tan Journal: J Orthop Surg (Hong Kong) Date: 2018 Jan-Apr Impact factor: 1.118
Authors: Andrew L Chen; Joel A Shapiro; Anthony K Ahn; Joseph D Zuckerman; Frances Cuomo Journal: J Shoulder Elbow Surg Date: 2003 Sep-Oct Impact factor: 3.019