Purpose
To evaluate whether glycemic control affects the integrity of the repaired rotator
cuff during the postoperative healing period after arthroscopic double-row suture
bridge rotator cuff repair (RCR)
Methods
We retrospectively reviewed patients with diabetes mellitus (DM) who underwent arthroscopic
double-row suture bridge RCR at our institution between March 2016 and November 2019.
We included the patients who evaluated for serum glycosylated hemoglobin (HbA1c) levels
within 1 month before and 3–6 months after surgery. Magnetic resonance imaging was
conducted 6 months after surgery to evaluate the integrity of the repaired cuff tendon.
Patients were categorized into two groups based on comparison between preoperative
and postoperative HbA1c values: Group I (increased postoperative HbA1c) and Group
D (same or decreased postoperative HbA1c). The correlation between preoperative/postoperative
HbA1c, HbA1c increase/same or decrease (during the healing period), and post-RCR integrity
was evaluated, including various demographic and radiologic factors.
Results
A total of 103 patients were analyzed, group I was 47, and group D was 56, respectively.
The retear rate of 51.1% (24/47) in Group I was significantly higher than 14.3% (8/56)
in Group D (P < .001). HbA1c levels measured 3-6 months after surgery (mean: 6.9; 95% CI: 6.6–7.3
vs mean: 6.5; 95% CI: 6.3–6.7, P = .034), and the proportion of group I and group D were significantly different (75%/25%
vs 32.4%/67.6%, P < .001) between the retear and healing groups. Multivariable logistic regression
analysis identified increased HbA1c as an independent risk factor for retear (odds
ratio: 5.402; 95% CI: 2.072–14.086; P < .001).
Conclusions
The glycemic control within 3-6 months after surgery when the healing process of the
tendon was in progress had a significant effect on retear rate. In particular, the
retear rate was higher when the HbA1c level increased at postoperative 3-6 months
compared to before surgery.
Level of Evidence
Retrospective case-control comparative study, Level III.
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Article Info
Publication History
Published online: August 29, 2022
Accepted:
August 14,
2022
Received:
March 3,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 by the Arthroscopy Association of North America
