Factores predictivos de rerrotura tras la reparación artroscópica del manguito rotador una revisión sistemática
DOI:
https://doi.org/10.5281/zenodo.22264616Palabras clave:
riesgo posoperatorio, factores pronósticos, infiltración grasa, falla estructural, cicatrización tendinosaResumen
La rerrotura constituye una de las principales limitaciones estructurales después de la reparación artroscópica del manguito rotador y su aparición responde a la interacción de condiciones del paciente, características de la lesión, calidad musculotendinosa y morfología del hombro. El objetivo consistió en identificar y sintetizar los factores predictivos asociados con falla estructural posterior a la reparación artroscópica. Se desarrolló una revisión sistemática orientada por PRISMA 2020, con una estrategia basada en PubMed/MEDLINE, Scopus, Web of Science, Embase y Cochrane Library, mediante términos relacionados con rotator cuff repair, retear, prognostic factors, fatty infiltration, tear size, tendon retraction, diabetes, smoking y variables radiológicas. La síntesis mostró mayor consistencia para edad avanzada, tamaño de la rotura, retracción tendinosa, infiltración grasa y atrofia muscular; diabetes mellitus y tabaquismo destacaron como factores potencialmente modificables, mientras que la distancia acromiohumeral y el ángulo crítico del hombro aportaron información complementaria. Se concluyó que la predicción clínica debe integrar múltiples variables y evitar decisiones basadas en un único marcador, favoreciendo estratificación preoperatoria, optimización de riesgos modificables y seguimiento individualizado.
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