Department of Orthopaedic Surgery, North Shore Hospital, Private Bag 93-503, Takapuna, Auckland 0740, New Zealand.
J Bone Joint Surg Am. 2013 May 15;95(10):910-5. doi: 10.2106/JBJS.L.00302.
Rotator cuff-tear arthropathy has traditionally represented a challenge to the shoulder arthroplasty surgeon. The poor results of conventional total shoulder arthroplasty in rotator-cuff-deficient shoulders due to glenoid component loosening have led to hemiarthroplasty being the traditional preferred surgical option. Recently, reverse total shoulder arthroplasty has gained increasing popularity because of a clinical perception of an improved functional outcome, despite the lack of comparative data. The aim of this study was to compare the early functional results of hemiarthroplasty with those of reverse shoulder arthroplasty in the management of cuff-tear arthropathy.
The results of 102 primary hemiarthroplasties for rotator cuff-tear arthropathy were compared with those of 102 reverse shoulder arthroplasties performed for the same diagnosis. Patients were identified from the New Zealand Joint Registry and matched for age, sex, and American Society of Anesthesiologists (ASA) scores. Oxford Shoulder Scores (OSS) collected at six months postoperatively as well as mortality and revision rates were compared between the two groups.
There were fifty-one men and fifty-one women in each group, with a mean age of 71.6 years in the hemiarthroplasty group and 72.6 years in the reverse shoulder arthroplasty group. The mean OSS at six months was 31.1 in the hemiarthroplasty group and 37.5 in the reverse shoulder arthroplasty group. At the time of follow-up, there were nine revisions in the hemiarthroplasty group and five in the reverse shoulder arthroplasty group. No difference in mortality rate was seen between the two groups.
In this unselected population with rotator cuff-tear arthropathy, controlled for age, sex, and ASA score, reverse shoulder arthroplasty resulted in a functional outcome that was superior to that of hemiarthroplasty. Longer-term follow-up is needed to confirm these findings.
肩袖撕裂性关节炎一直是肩关节置换术医生面临的挑战。由于肩胛盂部件松动，传统的全肩关节置换术在肩袖缺失的肩部效果不佳，导致半肩关节置换术成为传统的首选手术方案。最近，由于临床认为功能改善，反式全肩关节置换术越来越受欢迎，尽管缺乏比较数据。本研究旨在比较半肩关节置换术和反式肩关节置换术治疗肩袖撕裂性关节炎的早期功能结果。
从新西兰关节登记处确定了 102 例原发性肩袖撕裂性关节炎半肩关节置换术的结果，并与 102 例因相同诊断而行反式肩关节置换术的结果进行了比较。患者按年龄、性别和美国麻醉医师协会（ASA）评分进行匹配。比较两组术后 6 个月的牛津肩肘评分（OSS）以及死亡率和翻修率。
半肩关节置换组 51 例男性，51 例女性，平均年龄 71.6 岁；反式肩关节置换组 51 例男性，51 例女性，平均年龄 72.6 岁。半肩关节置换组术后 6 个月 OSS 平均为 31.1，反式肩关节置换组为 37.5。随访时，半肩关节置换组有 9 例翻修，反式肩关节置换组有 5 例翻修。两组死亡率无差异。
在未选择的肩袖撕裂性关节炎患者中，按年龄、性别和 ASA 评分进行匹配，反式肩关节置换的功能结果优于半肩关节置换。需要进行更长时间的随访以确认这些发现。
