Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL 32607, USA.
J Shoulder Elbow Surg. 2012 Mar;21(3):319-23. doi: 10.1016/j.jse.2011.05.023. Epub 2011 Aug 26.
Hemiarthroplasty was the treatment of choice for rotator cuff tear arthropathy (CTA) before the introduction of the reverse total shoulder arthroplasty (RTSA). The purpose of this study was to compare our outcomes for hemiarthroplasty with those for RTSA.
The records of patients with the diagnosis of CTA who had received either a hemiarthroplasty or RTSA from 1997 to 2007 were reviewed. A minimum of 2 years' follow-up was required. Active shoulder elevation, external rotation, internal rotation, and Shoulder Pain and Disability Index (SPADI) scores were obtained. Statistical analysis was performed comparing function, pain, and range of motion of hemiarthroplasty patients with RTSA patients.
We identified 56 shoulder arthroplasties in 50 patients with a minimum of 2 years' follow-up. There were 20 hemiarthroplasties and 36 RTSAs performed. The mean follow-up was 4.4 years (range, 2-12 years) in the hemiarthroplasty group and 3 years (range, 2-5 years) in the RTSA group. The mean age in the hemiarthroplasty group was 64 years versus 72 years in the RTSA group (P < .05). SPADI scores improved in both groups. However, after follow-up of 2 years or greater, the mean SPADI scores were significantly better (lower) in the RTSA group (34) than in the hemiarthroplasty group (58) (P = .005). Active elevation was significantly better in the RTSA group at all postoperative time periods. The complication rate for both groups was 25%.
RTSA performs better than hemiarthroplasty in terms of pain relief, function, and active elevation at 2-year follow-up.
在反式全肩关节置换术（RTSA）引入之前，半肩关节置换术是肩袖撕裂性关节炎（CTA）的治疗选择。本研究的目的是比较半肩关节置换术和 RTSA 的治疗效果。
回顾了 1997 年至 2007 年间接受半肩关节置换术或 RTSA 治疗的 CTA 患者的病历。需要至少 2 年的随访。获得了主动肩关节抬高、外旋、内旋和肩痛和残疾指数（SPADI）评分。对半肩关节置换术患者和 RTSA 患者的功能、疼痛和活动范围进行了统计学分析。
我们确定了 50 名患者的 56 例肩关节置换术，随访时间至少为 2 年。其中 20 例进行了半肩关节置换术，36 例进行了 RTSA。半肩关节置换组的平均随访时间为 4.4 年（范围，2-12 年），RTSA 组为 3 年（范围，2-5 年）。半肩关节置换组的平均年龄为 64 岁，RTSA 组为 72 岁（P<0.05）。两组的 SPADI 评分均有所改善。然而，随访 2 年或更长时间后，RTSA 组的平均 SPADI 评分（34）明显优于半肩关节置换组（58）（P=0.005）。RTSA 组在所有术后时间段的主动抬高都明显更好。两组的并发症发生率均为 25%。
在 2 年随访时，RTSA 在缓解疼痛、功能和主动抬高方面的表现优于半肩关节置换术。
