Background:In patients with hyperlipidemia, the risk of retear increases after rotator cuff repair (RCR). In particular, it has been reported that preoperative low-density lipoprotein cholesterol (LDL-C) level affects cuff integrity. However, there are no studies assessing whether lipidemic control affects cuff healing.Purpose:To evaluate the effect of preoperative lipidemic control on cuff integrity after arthroscopic RCR across cardiovascular disease risk groups in patients with hyperlipidemia.Study Design:Case-control study; Level of evidence, 3.Methods:The authors retrospectively reviewed the charts of patients with hyperlipidemia who underwent arthroscopic double-row suture bridge RCR between 2014 and 2019. The included patients had LDL-C tested within 1 month before surgery. Magnetic resonance imaging was conducted 6 months after surgery to evaluate the integrity of the repaired cuff tendon. Patients were divided into groups of low, moderate, high, and very high risk according to the 4th Korean Dyslipidemia Guidelines. On the basis of the target LDL-C set in each risk group, patients were categorized into 2 groups: group C (controlled hyperlipidemia, less than target LDL-C) and group U (uncontrolled hyperlipidemia, target LDL-C or greater). The correlation between serum lipid profile, lipidemic control, and post-RCR integrity was evaluated.Results:A total of 148 patients were analyzed, 51 in group U and 97 in group C. The retear rate was significantly higher in group U than in group C (23/51 [45.1%] vs 18/97 [18.6%], respectively; P = .001). The proportion of group U was significantly higher in the retear group than in the healing group (56.1% vs 26.2%; P = .001). In addition, the proportions of patients with uncontrolled diabetes mellitus (DM) (19.5% vs 3.7%; P = .002) and mediolateral (2.6 ± 1.2 cm vs 1.7 ± 1.1 cm; P < .001) and anteroposterior (2.2 ± 1.1 cm vs 1.6 ± 0.8 cm; P = .003) tear sizes were significantly different between the retear and healing groups, respectively. No significant difference in serum lipid profile, including LDL-C level (119.6 ± 31.3 vs 116.7 ± 37.2; P = .650), was observed between the retear and healing groups. Multivariate regression analysis identified uncontrolled hyperlipidemia (OR, 4.005; P = .001), uncontrolled DM (OR, 5.096; P = .022), and mediolateral tear size (OR, 1.764; P = .002) as independent risk factors for retear. The 2.0-cm mediolateral size cutoff and the 3 independent risk factors had significant associations with retear.Conclusion:Poor preoperative lipidemic control was significantly associated with poor healing after RCR. In addition to large mediolateral tear size, uncontrolled hyperlipidemia and DM were significant risk factors for retear. Moreover, poor lipidemic control compared with the recommended target level before surgery was more correlated with an increased retear rate than a preoperative LDL-C level.

中文翻译：

---

术前血脂控制对高脂血症患者肩袖修复术后视网膜恢复率的影响


背景：在高脂血症患者中，肩袖修复术（RCR）后发生视网膜后退的风险增加。特别是，据报道，术前低密度脂蛋白胆固醇（LDL-C）水平会影响袖带的完整性。然而，尚无研究评估血脂控制是否影响袖带愈合。目的：评估术前血脂控制对高脂血症患者心血管疾病危险人群关节镜下RCR术后袖带完整性的影响。证据级别，3。方法：作者回顾性分析了2014年至2019年接受关节镜双排缝合桥RCR的高脂血症患者的图表。纳入的患者在术前1个月内进行了LDL-C检测。术后 6 个月进行磁共振成像，以评估修复后的袖带肌腱的完整性。根据第四版韩国血脂异常指南，将患者分为低风险、中风险、高风险和极高风险组。根据每个风险组设定的目标 LDL-C，将患者分为 2 组：C 组（高脂血症受控，低于 LDL-C 目标）和 U 组（高脂血症未受控制，LDL-C 目标或更高）。评估血脂、血脂控制和RCR后完整性之间的相关性。结果：总共分析了148例患者，其中U组51例，C组97例。U组的延迟率显着高于C组C（分别为 23/51 [45.1%] 与 18/97 [18.6%]；P = .001）。复位组中 U 组的比例显着高于愈合组（56.1% vs 26.2%；P = .001）。此外，未受控制的糖尿病 (DM) 患者的比例（19.5% vs 3.5%）7%； P = .002）、内侧（2.6 ± 1.2 cm vs 1.7 ± 1.1 cm；P < .001）和前后（2.2 ± 1.1 cm vs 1.6 ± 0.8 cm；P = .003）撕裂尺寸在后部和后部之间存在显着差异。分别为治疗组。修复组和愈合组之间的血清脂质谱（包括 LDL-C 水平）没有显着差异（119.6 ± 31.3 vs 116.7 ± 37.2；P = .650）。多变量回归分析确定未控制的高脂血症 (OR, 4.005; P = .001)、未控制的 DM (OR, 5.096; P = .022) 和内侧撕裂尺寸 (OR, 1.764; P = .002) 为眼后角膜后的独立危险因素。 2.0 cm 中外侧尺寸临界值和 3 个独立危险因素与术后复发显着相关。结论：术前血脂控制不良与 RCR 术后愈合不良显着相关。除了中外侧撕裂尺寸较大之外，未控制的高脂血症和糖尿病也是视网膜再发育的重要危险因素。此外，与术前推荐的目标水平相比，血脂控制不佳与术后延迟率增加的相关性高于术前 LDL-C 水平。