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肱骨半关节置换术与反式全肩关节置换术后工作相关结果的比较分析。

A comparative analysis of work-related outcomes after humeral hemiarthroplasty and reverse total shoulder arthroplasty.

作者信息

Hurwit Daniel J, Liu Joseph N, Garcia Grant H, Mahony Gregory, Wu Hao-Hua, Dines David M, Warren Russell F, Gulotta Lawrence V

机构信息

Hospital for Special Surgery, New York, NY, USA.

Hospital for Special Surgery, New York, NY, USA.

出版信息

J Shoulder Elbow Surg. 2017 Jun;26(6):954-959. doi: 10.1016/j.jse.2016.10.004. Epub 2017 Jan 11.

Abstract

BACKGROUND

The return to work of young patients undergoing shoulder arthroplasty is increasingly important. Whereas studies have shown superior outcomes of reverse total shoulder arthroplasty (RTSA) compared with humeral hemiarthroplasty (HHA), no prior literature has compared RTSA with HHA in regard to return to work.

METHODS

A retrospective review of a prospectively collected shoulder arthroplasty registry was performed to analyze all patients who underwent RTSA or HHA at a single institution. A validated questionnaire evaluating return to work postoperatively was administered at baseline and at follow-up in addition to the American Shoulder and Elbow Surgeons and visual analog scale (VAS) pain surveys.

RESULTS

The study included 40 RTSA and 41 HHA patients. The average age at surgery was 68.6 years in the RTSA group and 60.8 years in the HHA group (P < .001). Postoperatively, 65% of RTSA patients returned to work compared with 70.7% of HHA patients (P = .64). There was no significant difference in the time to return to work between the RTSA (2.3 months) and HHA (3.1 months) groups (P = .46). Both groups had statistically significant improvements in both the American Shoulder and Elbow Surgeons and VAS scores. The improvement in pain on the VAS for patients undergoing RTSA (-5.6) trended toward significance compared with HHA (-4.2) (P = .056).

CONCLUSION

Roughly two-thirds of patients undergoing either HHA or RTSA were able to return to work postoperatively, with no significant difference found between the 2 groups in terms of time to return to work, despite that patients undergoing RTSA were significantly older.

摘要

背景

接受肩关节置换术的年轻患者恢复工作变得越来越重要。尽管研究表明,与肱骨半关节置换术(HHA)相比,反式全肩关节置换术(RTSA)的效果更佳,但此前尚无文献比较RTSA和HHA在恢复工作方面的差异。

方法

对前瞻性收集的肩关节置换术登记资料进行回顾性分析,以分析在单一机构接受RTSA或HHA手术的所有患者。除了美国肩肘外科医师协会(ASES)和视觉模拟评分(VAS)疼痛调查外,还在基线和随访时使用一份经过验证的问卷评估术后恢复工作情况。

结果

该研究纳入了40例接受RTSA手术的患者和41例接受HHA手术的患者。RTSA组的平均手术年龄为68.6岁,HHA组为60.8岁(P <.001)。术后,65%的RTSA患者恢复工作,而HHA患者的这一比例为70.7%(P = 0.64)。RTSA组(2.3个月)和HHA组(3.1个月)恢复工作的时间没有显著差异(P = 0.46)。两组患者的ASES和VAS评分均有统计学意义的改善。RTSA患者(-5.6)的VAS疼痛改善程度与HHA患者(-4.2)相比有显著差异(P = 0.056)。

结论

接受HHA或RTSA手术的患者中,约三分之二能够在术后恢复工作,尽管接受RTSA手术的患者年龄明显较大,但两组在恢复工作的时间方面没有显著差异。

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