Somerson Jeremy S, Neradilek Moni B, Hsu Jason E, Service Benjamin C, Gee Albert O, Matsen Frederick A
The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555, USA.
The Mountain-Whisper-Light Statistics, 1827 23rd Avenue East, Seattle, WA, 98112, USA.
Int Orthop. 2017 Jun;41(6):1235-1244. doi: 10.1007/s00264-017-3443-0. Epub 2017 Mar 28.
Have the results of shoulder arthroplasty got better over the last two decades? To answer this question, we sought published evidence that the patient-reported outcomes and re-operation rates have improved in reports of more recently performed anatomic (TSA) and reverse (RSA) total shoulder arthroplasties.
We analyzed the arthroplasty results among studies published from 1990 to 2015, adjusting for the fact that the different publications presented patient groups with different combinations of diagnoses, used various outcome scales, and had different lengths of follow-up.
The adjusted clinical outcomes (p = 0.048), but not the revision rates (p = 0.3), were significantly better for articles reporting more recent TSA procedures. Neither the clinical outcomes (p = 0.9) nor the revision rates (p = 0.4) were significantly better in articles reporting more recent RSA surgeries.
Better evidence from reports with greater detail will be necessary to show that patients are realizing progressively better outcomes from shoulder arthroplasty.
Level IV.
在过去二十年中，肩关节置换术的结果是否有所改善？为了回答这个问题，我们寻找已发表的证据，以证明在最近进行的解剖型（TSA）和反置型（RSA）全肩关节置换术的报告中，患者报告的结果和再次手术率有所改善。
我们分析了1990年至2015年发表的研究中的关节置换术结果，并考虑到不同出版物所呈现的患者群体具有不同的诊断组合、使用了各种结果量表且随访时间不同这一事实进行了调整。
报告近期TSA手术的文章中，调整后的临床结果（p = 0.048）显著更好，但翻修率（p = 0.3）并非如此。报告近期RSA手术的文章中，临床结果（p = 0.9）和翻修率（p = 0.4）均无显著改善。
需要来自更详细报告的更好证据，以表明患者从肩关节置换术中获得的结果正在逐步改善。
IV级。
