Romano Alfonso Maria, Oliva Francesco, Nastrucci Guglielmo, Casillo Pasquale, Di Giunta Angelo, Susanna Massimiliano, Ascione Francesco
Orthopedic Division, Campolongo Hospital, Salerno, Italy.
Department of Orthopaedics and Traumatology, University of Rome "Tor Vergata", Rome, Italy.
Muscles Ligaments Tendons J. 2017 Sep 18;7(2):263-270. doi: 10.11138/mltj/2017.7.2.263. eCollection 2017 Apr-Jun.
Rehabilitation after Reverse Shoulder Arthroplasty (RSA) is still object of discussion with no based evidence guidelines. The aim of this study was to test a personalized rehabilitation protocol for three different patients groups according to clinical and intraoperative parameters that can affect final outcomes after RSA.
We retrospectively evaluated a consecutive series of 112 patients who underwent to RSA between 2013 and 2015. The average follow-up was 29.2 months. A preoperative and postoperative clinical and radiographic assessment was performed. According to clinical, radiographic and intraoperative parameters, we selected three groups dedicating each one a specific level of post surgical care.
A statistically significant improvement was achieved from preoperative evaluation, regarding all analysed parameters. Notable improvements were reported in high care group: elevation improved of 63.9° despite of Group A 55.5° and Group B 54.5° and it resulted statistically significant (< 0.05). Costant Score increased of 35.9%, despite of Group A and Group B respectively 40.6% and 34.8% (> 0.05).
Our study shows that a personalized rehabilitation protocol can be effective improving clinical outcomes and decreasing complications rate, particularly in difficult management patients.
Therapeutic Level IV.
反肩关节置换术（RSA）后的康复仍是一个存在争议的话题，目前尚无基于证据的指南。本研究的目的是根据可能影响RSA术后最终结果的临床和术中参数，为三个不同患者群体测试个性化康复方案。
我们回顾性评估了2013年至2015年间连续接受RSA手术的112例患者。平均随访时间为29.2个月。进行了术前和术后的临床及影像学评估。根据临床、影像学和术中参数，我们选择了三组患者，每组给予特定水平的术后护理。
从术前评估来看，所有分析参数均有统计学意义上的显著改善。高护理组报告了显著改善：尽管A组改善了55.5°，B组改善了54.5°，但高护理组抬高角度改善了63.9°，差异有统计学意义（<0.05）。Constant评分提高了35.9%，尽管A组和B组分别提高了40.6%和34.8%（>0.05）。
我们的研究表明，个性化康复方案可有效改善临床结果并降低并发症发生率，尤其是在管理困难的患者中。
治疗性四级。
