Garcia Grant H, Taylor Samuel A, DePalma Brian J, Mahony Gregory T, Grawe Brian M, Nguyen Joseph, Dines Joshua S, Dines David M, Warren Russell F, Craig Edward V, Gulotta Lawrence V
Hospital for Special Surgery, New York, New York, USA
Hospital for Special Surgery, New York, New York, USA.
Am J Sports Med. 2015 Nov;43(11):2816-21. doi: 10.1177/0363546515597673. Epub 2015 Aug 27.
The indications for reverse total shoulder arthroplasty (RTSA) continue to expand, which has resulted in younger patients who want to remain active after RTSA. Little information is available to manage expectations of both physicians and patients for return to sporting activities.
To determine the rate of return to sporting activities and assess average time to return to sports after RTSA.
Case series; Level of evidence, 4.
This was a retrospective review of consecutive RTSA patients collected from our institution's shoulder arthroplasty registry. All patients who played sports preoperatively and had a minimum of 1-year follow-up were included. Final follow-up consisted of an additional patient-reported questionnaire with questions regarding physical fitness and sporting activities. Each patient also completed an assessment with the American Shoulder and Elbow Society (ASES) Shoulder Score and a visual analog scale (VAS) for pain.
Seventy-six patients played a sport preoperatively and met inclusion and exclusion criteria. The average follow-up was 31.6 months (range, 12-65 months), and average age was 74.8 years (range, 49.9-92.6 years). Average VAS pain scores improved from 6.57 to 0.63 (P < .001). Average ASES scores improved from 34.30 to 81.45 (P < .001). Subjectively, 11.8% of patients complained of stiffness and 10.5% complained of chronic pain. After RTSA, 85.5% of patients returned to at least 1 sport. Average time to return to full sports was 5.3 months. Fitness sports had the highest direct rate of return (81.5%), followed by swimming (66.7%), running (57.1%), cycling (50.0%), and golf (50%). Postoperatively, 41.1% of patients reported improved physical fitness; 88.2% felt that their sports outcome was good to excellent, and 93.4% felt that their surgical outcome was good to excellent.
Patients undergoing RTSA had an 85% rate of return to 1 or more sporting activities at an average of 5.3 months after surgery. Age greater than 70 years was a significant predictor of decreased return to activities. The present study offers valuable information to help manage patient and surgeon expectations.
反式全肩关节置换术（RTSA）的适应症不断扩大，这使得一些年轻患者在接受RTSA后仍希望保持活跃。关于如何管理医生和患者对恢复体育活动的期望，目前几乎没有相关信息。
确定RTSA后恢复体育活动的比例，并评估恢复运动的平均时间。
病例系列；证据等级，4级。
这是一项对从我们机构的肩关节置换术登记处收集的连续RTSA患者进行的回顾性研究。纳入所有术前进行体育活动且至少随访1年的患者。最终随访包括一份额外的患者报告问卷，其中包含有关身体健康和体育活动的问题。每位患者还完成了美国肩肘协会（ASES）肩部评分评估和疼痛视觉模拟量表（VAS）评估。
76例患者术前进行体育活动，符合纳入和排除标准。平均随访时间为31.6个月（范围12 - 65个月），平均年龄为74.8岁（范围49.9 - 92.6岁）。VAS疼痛平均评分从6.57改善至0.63（P <.001）。ASES平均评分从34.30提高到81.45（P <.001）。主观上，11.8%的患者抱怨有僵硬感，10.5%的患者抱怨有慢性疼痛。RTSA后，85.5%的患者恢复了至少一项运动。恢复全面运动的平均时间为5.3个月。健身运动的直接恢复率最高（81.5%），其次是游泳（66.7%）、跑步（57.1%）、骑自行车（50.0%）和高尔夫（50%）。术后，41.1%的患者报告身体健康有所改善；88.2%的患者认为他们的运动结果良好至优秀，93.4%的患者认为他们的手术结果良好至优秀。
接受RTSA的患者术后平均5.3个月恢复一项或多项体育活动的比例为85%。年龄大于70岁是活动恢复率下降的一个重要预测因素。本研究提供了有价值的信息，有助于管理患者和外科医生的期望。
