Simovitch Ryan W, Gerard Berenice K, Brees Jordon A, Fullick Robert, Kearse Justin C
Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA.
Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL, USA.
J Shoulder Elbow Surg. 2015 Sep;24(9):1481-5. doi: 10.1016/j.jse.2015.03.011. Epub 2015 May 7.
This study evaluated the clinical and radiographic outcomes of reverse total shoulder arthroplasty (RTSA) in a senior athletic population playing both low- and high-impact sports.
We evaluated 41 RTSAs performed in 40 patients who continued to play both low- and high-impact sports after surgery. The mean age was 73 years, and the mean follow-up period was 43 months, with a minimum of 35 months. Clinical and radiographic outcomes were examined.
Ninety-five percent of patients indicated that they were able to return to sports at the same level as before surgery or at a higher level, and only 13% reported increased pain after playing their sport after undergoing an RTSA. The median American Shoulder and Elbow Surgeons score improved from 31 preoperatively to 72 postoperatively (P < .001). The median Constant score improved from 25 preoperatively to 83 postoperatively (P < .001). The median Subjective Shoulder Value improved from 27% preoperatively to 90% postoperatively (P < .001), and the median visual analog scale score improved from 7.2 preoperatively to 1.1 postoperatively (P < .001). The overall complication rate was 7%. One zone of lucency was noted in 17% of humeral stems, with 1 case of early subsidence but no cases with loosening at final follow-up. The glenoid notching rate was 7%, with no cases of glenoid subsidence, lucency, or loosening.
RTSA in senior athletes can be safely performed with good clinical results. No prominent mode of mechanical or clinical failure has been identified with short-term follow-up.
本研究评估了在从事低强度和高强度运动的老年运动员群体中,反式全肩关节置换术(RTSA)的临床和影像学结果。
我们评估了40例患者接受的41例RTSA手术,这些患者术后继续从事低强度和高强度运动。平均年龄为73岁,平均随访期为43个月,最短随访期为35个月。对临床和影像学结果进行了检查。
95%的患者表示他们能够恢复到术前相同水平或更高水平的运动,只有13%的患者报告在接受RTSA手术后运动后疼痛加剧。美国肩肘外科医生评分中位数从术前的31分提高到术后的72分(P <.001)。Constant评分中位数从术前的25分提高到术后的83分(P <.001)。主观肩关节价值评分中位数从术前的27%提高到术后的90%(P <.001),视觉模拟量表评分中位数从术前的7.2分提高到术后的1.1分(P <.001)。总体并发症发生率为7%。17%的肱骨干出现一个透亮区,有1例早期下沉,但在最后随访时无松动病例。肩胛盂切迹发生率为7%,无肩胛盂下沉、透亮或松动病例。
老年运动员的RTSA手术可以安全进行,临床效果良好。短期随访未发现明显的机械或临床失败模式。