Churchill R Sean
Orthopaedics, Advanced Healthcare, SC, Milwaukee, WI, USA.
J Shoulder Elbow Surg. 2008 May-Jun;17(3):376-9. doi: 10.1016/j.jse.2007.09.005. Epub 2008 Feb 14.
This study examined the outcome of elective shoulder arthroplasty for glenohumeral osteoarthritis or rotator cuff arthropathy in patients aged older than 90 years. The study included 7 shoulders in 6 patients with an average age of 93 years 5 months, (range, 91 years 0 months to 97 years 4 months). Average follow-up was 2.2 years, (range, 1-4 years). Preoperative range of motion, Simple Shoulder Test (SST) scores, and Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36) scores were obtained and compared with postoperative values at 3 and 6 months and yearly thereafter. Average forward elevation improved from 87 degrees to 137 degrees (P < .00001), and external rotation to the side improved from 0 degrees to 50 degrees (P < .0001). The SST scores improved from a preoperative average of 2.0 to 6.1 at 3 months (P < .0001), 6.9 at 6 months (P < .0001), 8.0 at 1 year (P < .00001), and 7.4 at 2 years (P < .0001). Significant improvements occurred in 6 of 8 SF-36 domains: Mental Health (P < .05), Vitality (P < .01), Role limitations due to emotional problems (P < .05), Social Function (P < .001), Role limitations due to physical health (P < .001), and Comfort (P < .00001). No patient had worse pain or function postoperatively. These data suggest that elective shoulder arthroplasty can be performed in patients 90 years of age and older, providing excellent pain relief, improved functional outcome, and enhanced general health status.
本研究调查了年龄超过90岁的患者因盂肱关节骨关节炎或肩袖关节病接受择期肩关节置换术的结果。该研究纳入了6例患者的7个肩关节,平均年龄为93岁5个月(范围为91岁0个月至97岁4个月)。平均随访时间为2.2年(范围为1 - 4年)。记录术前活动范围、简易肩关节测试(SST)评分以及医学结局研究简明健康调查36项量表(SF - 36)评分,并与术后3个月、6个月及之后每年的数值进行比较。平均前屈上举从87度提高到137度(P <.00001),向体侧外旋从0度提高到50度(P <.0001)。SST评分从术前平均2.0分在3个月时提高到6.1分(P <.0001),6个月时为6.9分(P <.0001),1年时为8.0分(P <.00001),2年时为7.4分(P <.0001)。SF - 36的8个领域中有6个出现显著改善:心理健康(P <.05)、活力(P <.01)、因情绪问题导致的角色受限(P <.05)、社会功能(P <.001)、因身体健康导致的角色受限(P <.001)和舒适度(P <.00001)。没有患者术后疼痛或功能变差。这些数据表明,90岁及以上患者可以接受择期肩关节置换术,能提供出色的疼痛缓解、改善功能结局并提高总体健康状况。