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为接受工伤赔偿的患者进行解剖型全肩关节置换术。

Anatomic total shoulder arthroplasty for patients receiving workers' compensation.

作者信息

Jawa Andrew, Dasti Umer R, Fasulo Sydney M, Vaickus Max H, Curtis Alan S, Miller Suzanne L

机构信息

Tufts University Medical School, Boston, MA, USA; The New England Baptist Hospital, Boston, MA, USA; Boston Sports and Shoulder Center, Chestnut Hill, MA, USA.

The New England Baptist Hospital, Boston, MA, USA.

出版信息

J Shoulder Elbow Surg. 2015 Nov;24(11):1694-7. doi: 10.1016/j.jse.2015.04.017. Epub 2015 Jul 6.

Abstract

BACKGROUND

Studies have demonstrated that receiving workers' compensation (WC) benefits can be a negative predictor of outcomes after orthopedic procedures. This study compares postoperative outcomes of anatomic total shoulder arthroplasty (TSA) between patients receiving WC benefits and a control group that did not.

METHODS

A cohort of 13 consecutive TSA patients with WC benefits were compared with a control group of 63 consecutive patients with a minimum of 2 years of follow-up during the same period. Patient demographics, American Shoulder and Elbow Surgeons scores, 12-Item Short Form Health Survey scores, return to work status, and time out of work were evaluated.

RESULTS

The WC TSA cohort consisted of 13 men and no women with a mean age of 55.9 years. Twelve of the 13 were laborers. The TSA control group consisted of 36 men and 27 women with a mean age of 63.2 years (P = .01). The American Shoulder and Elbow Surgeons scores at final follow-up were significantly lower in the WC cohort (73.6) compared with the control group (86.6; P = .01). However, the 12-Item Short Form Health Survey physical and mental component summary scores were not significantly different (P = .09 and P = .6). Only 4 of the 13 WC patients returned to work.

CONCLUSION

Compared with a non-WC population, patients with WC who received an anatomic TSA are more likely to be male, younger, and a laborer. Outcomes are generally excellent and better than those of other WC shoulder surgery cohorts in the literature; however, the outcomes are relatively worse than in the non-WC TSA patients. A significant number of WC patients are unable to return to work after TSA.

摘要

背景

研究表明,获得工伤赔偿(WC)福利可能是骨科手术后预后的负面预测因素。本研究比较了获得WC福利的患者与未获得该福利的对照组在解剖型全肩关节置换术(TSA)后的术后结果。

方法

将一组连续的13例接受TSA且获得WC福利的患者与同期一组连续的63例患者组成的对照组进行比较,对照组患者至少随访2年。评估患者的人口统计学特征、美国肩肘外科医师协会评分、12项简明健康调查问卷评分、重返工作状态和误工时间。

结果

获得WC福利的TSA队列包括13名男性,无女性,平均年龄55.9岁。13名患者中有12名是劳动者。TSA对照组包括36名男性和27名女性,平均年龄63.2岁(P = 0.01)。最终随访时,获得WC福利的队列中美国肩肘外科医师协会评分(73.6)显著低于对照组(86.6;P = 0.01)。然而,12项简明健康调查问卷的身体和心理成分总结评分无显著差异(P = 0.09和P = 0.6)。13名获得WC福利的患者中只有4人重返工作岗位。

结论

与未获得WC福利的人群相比,接受解剖型TSA且获得WC福利的患者更可能为男性、更年轻且为劳动者。总体预后通常良好,且优于文献中其他获得WC福利的肩部手术队列;然而,其预后相对比未获得WC福利的TSA患者差。大量获得WC福利的患者在TSA术后无法重返工作岗位。

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