Morris Brent J, Haigler Richard E, O'Connor Daniel P, Elkousy Hussein A, Gartsman Gary M, Edwards T Bradley
Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX, USA.
J Shoulder Elbow Surg. 2015 Mar;24(3):474-81. doi: 10.1016/j.jse.2014.08.008. Epub 2014 Oct 16.
The purpose of this study was to evaluate outcomes in patients with rotator cuff tear arthropathy after staged bilateral reverse shoulder arthroplasties (RSAs) and to compare them with an age-, gender-, and diagnosis-matched control group with a unilateral RSA.
We identified 11 patients with bilateral RSAs for rotator cuff tear arthropathy with a minimum of 2-year follow-up in a prospective shoulder arthroplasty registry. The bilateral group was matched to a control group of 19 patients with a unilateral RSA. Shoulder function scores, mobility, patient satisfaction, and activities of daily living were assessed preoperatively and at final follow-up.
There was no statistical difference between the first RSA or second RSA and the control group regarding age, gender, or follow-up. No group differences were noted preoperatively for shoulder function scores or mobility (P > .10). All groups significantly improved on all shoulder function scores (Constant score, American Shoulder and Elbow Surgeons score, Western Ontario Osteoarthritis of the Shoulder index, Single Assessment Numeric Evaluation score) and mobility at final follow-up (all P < .01). There were no significant differences in shoulder function scores or mobility between the first and second RSA in the bilateral group or between either shoulder in the bilateral group and the unilateral group (all P > .10). Patient satisfaction improved and patients were successfully able to perform many important activities of daily living after bilateral RSAs.
Patients with bilateral rotator cuff tear arthropathy can be advised that staged bilateral RSAs can be successful when indicated. Improvements in shoulder function scores, patient satisfaction, and mobility are possible for both the first RSA and the second RSA.
本研究的目的是评估分期双侧反肩关节置换术（RSA）治疗肩袖撕裂性关节病患者的疗效，并将其与年龄、性别和诊断相匹配的单侧RSA对照组进行比较。
我们在一个前瞻性肩关节置换登记处确定了11例接受双侧RSA治疗肩袖撕裂性关节病的患者，至少随访2年。双侧组与19例接受单侧RSA的对照组进行匹配。在术前和最终随访时评估肩关节功能评分、活动度、患者满意度和日常生活活动能力。
在年龄、性别或随访方面，第一次RSA或第二次RSA与对照组之间无统计学差异。术前肩关节功能评分或活动度在各组之间无差异（P>.10）。所有组在最终随访时所有肩关节功能评分（Constant评分、美国肩肘外科医师协会评分、西加拿大肩关节炎指数、单评估数字评价评分）和活动度均有显著改善（所有P<.01）。双侧组中第一次和第二次RSA之间或双侧组的任何一侧肩关节与单侧组之间在肩关节功能评分或活动度方面均无显著差异（所有P>.10）。双侧RSA后患者满意度提高，患者能够成功进行许多重要的日常生活活动。
对于双侧肩袖撕裂性关节病患者，可以告知他们，在有指征时分期双侧RSA可能会成功。第一次RSA和第二次RSA在肩关节功能评分、患者满意度和活动度方面均有可能改善。
