A Prospective Follow-up of Patients Treated Surgically or Non-Surgically for Full-thickness Rotator Cuff Tears
Notice bibliographique
Résumé
Objectives: The objectives of this project are: (1) to compare the efficacy of surgical versus non-surgical management of full-thickness rotator cuff tears, and (2) to detect variables that predict success within each treatment group. Methods: Patients who presented to our care for management of symptomatic full-thickness rotator cuff tears were enrolled in our Shoulder Registry and clinical data were collected prospectively. In addition to baseline demographic information, the following outcome measures were collected at baseline, 6 months, 1 year and annually up to 3 years: Western Ontario Rotator Cuff (WORC) Index, American Shoulder and Elbow Surgeons (ASES) score, Modified Marx Shoulder Activity Level Scale, VR-12, 100-point Single Assessment Numeric Evaluation (SANE) rating, 100-point visual analog scale (VAS) for pain, and a patient satisfaction scale. All patients were allocated treatment as recommended by the attending surgeon. We described all patient demographic characteristics, and performed linear and logistic regression for variables associated with treatment allocation and with treatment effects. We also used Student’ t-tests and Wilcoxon rank-sum tests where appropriate, to explore differences in treatment effects between the groups for all outcome measures at all time points. Results: A total of 292 patients were included with 155 allocated to surgery and 137 to non-surgical treatment. Those allocated to surgery were younger (58.6 years vs 65.2 years; P<.0001), less likely to have diabetes (12% vs 21%; P=0.05), more likely to have a known traumatic injury (71% vs 55%; P=0.002), and tended to be worse off on all outcome measures at baseline then the non-surgical group. Both the surgical group and non-surgical group improved on all outcome measures across the follow up period with several variables predicting changes at each time point. Table 1 contains the list of specific variables that predicted improved outcomes separately for both treatment groups. Also, at one year the surgical group improvement was significantly greater than the non-surgical group on all outcome measures. At both two and three years the surgical group showed a significantly greater degree of improvement than the non-surgical group on both the WORC index and the ASES score. Conclusion: We found that patients with rotator cuff tears who undergo surgical or nonsurgical treatment tend to improve, with patients allocated to surgery improving to a greater degree across three years of follow-up. In addition, there appear to be important predictors of improved outcomes that may help us to tailor our treatments to individuals with specific characteristics.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».