Garcia Grant H, Mahony Gregory T, Fabricant Peter D, Wu Hao-Hua, 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. 2016 Feb;44(2):490-6. doi: 10.1177/0363546515613077. Epub 2015 Dec 9.
With an active aging population, more patients expect to return to previous activities and work after surgery.
To determine the rate and timing to return of sports and employment after shoulder hemiarthroplasty.
Case series; Level of evidence, 4.
This was a retrospective review of consecutive patients who underwent shoulder hemiarthroplasty from 2007 to 2013. Follow-up consisted of a patient-reported questionnaire regarding physical fitness, sporting activities, and work status.
From 105 patients screened, 79 were available for follow-up. The average follow-up time was 63.1 months, and the average age at follow-up was 69 years. Scores on the visual analog scale for pain improved from 6.2 to 2.1 (P < .001) postoperatively, and those on the American Shoulder and Elbow Surgeons (ASES) shoulder assessment improved from 34.6 to 71.3 (P < .001). Patients older than 65 years had significantly lower absolute postoperative ASES scores (P = .041) but experienced similar improvement from their preoperative baseline (P = .158) compared with patients younger than 65 years. There were 58 patients who played sports preoperatively, and 67.2% of these restarted at least 1 of their previous sports postoperatively. The average time to return to full sports was 6.5 months for those who returned. Direct rates of return were as follows: fitness sports (69%), swimming (65%), running (64%), cycling (63%), and doubles tennis (57%). Younger age was associated with highest demand level achieved (P = .023). Forty-nine patients worked preoperatively, with 69.4% returning to previous employment after surgery; the average time to return to work was 1.4 months. In comparative analysis, patients who did not return to work had a higher mean body mass index (32 ± 7 vs 27 ± 5 kg/m(2); P < .008).
In this hemiarthroplasty cohort, there was a 67.2% rate of return to 1 or more sports at an average of 6.5 months postoperatively. Patients older than 65 years experienced similar improvements in ASES scores compared with patients younger than 65 years, although absolute scores were lower on average. Those who returned to higher demand sports were younger on average. Of patients working preoperatively, 69.4% returned to their previous employment at an average of 1.4 months. Patients who did not return to employment had significantly higher body mass index on average. These findings will help surgeons manage expectations of shoulder hemiarthroplasty candidates preoperatively.
随着老年人口的日益活跃，越来越多的患者期望术后能恢复之前的活动和工作。
确定肩关节半关节置换术后恢复运动和工作的比例及时间。
病例系列；证据等级，4级。
对2007年至2013年连续接受肩关节半关节置换术的患者进行回顾性研究。随访采用患者报告的关于身体健康、体育活动和工作状态的问卷。
在筛选的105例患者中，79例可供随访。平均随访时间为63.1个月，随访时的平均年龄为69岁。术后视觉模拟疼痛评分从6.2改善至2.1（P <.001），美国肩肘外科医师学会（ASES）肩关节评估评分从34.6提高至71.3（P <.001）。65岁以上的患者术后ASES绝对评分显著较低（P = 0.041），但与65岁以下的患者相比，其术前基线的改善情况相似（P = 0.158）。术前有58例患者进行体育活动，其中67.2%的患者术后至少重新开始了1项之前的运动。恢复运动的患者恢复到完全运动的平均时间为6.5个月。直接恢复率如下：健身运动（69%）、游泳（65%）、跑步（64%）、骑自行车（63%）和双打网球（57%）。年龄较小与达到的最高需求水平相关（P = 0.023）。49例患者术前工作，术后69.4%的患者恢复了之前的工作；平均恢复工作时间为1.4个月。在比较分析中，未恢复工作的患者平均体重指数较高（32±7 vs 27±5 kg/m²；P < 0.008）。
在这个半关节置换术队列中，术后平均6.5个月时，恢复1项或更多运动的比例为67.2%。65岁以上的患者与65岁以下的患者相比，ASES评分的改善情况相似，尽管平均绝对评分较低。恢复到更高需求运动的患者平均年龄较小。术前工作的患者中，69.4%的患者平均在1.4个月后恢复了之前的工作。未恢复工作的患者平均体重指数显著较高。这些发现将有助于外科医生在术前管理肩关节半关节置换术候选患者的期望。
