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年轻患者行反式全肩关节置换术后的效果更好吗?

Do younger patients have better results after reverse total shoulder arthroplasty?

机构信息

Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA, USA.

Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA, USA.

出版信息

J Shoulder Elbow Surg. 2018 Jun;27(6S):S24-S28. doi: 10.1016/j.jse.2017.11.014. Epub 2018 Jan 5.

DOI:10.1016/j.jse.2017.11.014
PMID:29307669
Abstract

BACKGROUND

As surgeons have become more adept and midterm to long-term results have demonstrated improved patient outcomes, the indications for reverse total shoulder arthroplasty (RTSA) have expanded. This study compares the clinical outcomes and complication rates between patients 65 years and younger and patients 70 years and older undergoing RTSA.

METHODS

A retrospective analysis of a prospectively collected cohort with minimum 2-year follow-up was performed at a single institution. Patient demographic data, American Shoulder and Elbow Surgeons (ASES) score, range of motion, patient satisfaction, notching, and complication rates were analyzed.

RESULTS

There were 32 patients (57 ± 4.9 years old) in the 65 years and younger group, whereas 50 patients (76 ± 4.9 years old) were in the 70 years and older group. The mean follow-up time was 3 years (range, 2-8 years). There were no significant differences in preoperative, postoperative, or change in ASES scores between the younger and older groups. Postoperatively, the younger cohort achieved a higher degree (mean) of forward flexion (133° vs. 117°), abduction (127° vs. 110°), and external rotation (40° vs. 27°) (P < .05). The average improvement in forward flexion and external rotation was also found to be larger in the younger cohort (P < .05). The younger and older groups had comparable complication rates, notching rates, and overall satisfaction rates.

CONCLUSION

Patient-reported outcomes scores and complication rates after RTSA of patients aged 65 years and younger were similar to those of patients aged 70 years and older. However, younger patients were able to achieve increased postoperative range of motion.

摘要

背景

随着外科医生技术的日益精湛,中期至长期结果表明患者的预后得到改善,反向全肩关节置换术(RTSA)的适应证不断扩大。本研究比较了 65 岁及以下和 70 岁及以上接受 RTSA 的患者的临床结果和并发症发生率。

方法

对一家单机构前瞻性收集的队列进行回顾性分析,随访时间至少为 2 年。分析患者的人口统计学数据、美国肩肘外科医师协会(ASES)评分、活动范围、患者满意度、肩峰下切迹和并发症发生率。

结果

65 岁及以下组有 32 例患者(57±4.9 岁),70 岁及以上组有 50 例患者(76±4.9 岁)。平均随访时间为 3 年(范围 2-8 年)。两组间术前、术后和 ASES 评分的变化无显著差异。术后,年轻组的前屈角度(平均 133° vs. 117°)、外展角度(平均 127° vs. 110°)和外旋角度(平均 40° vs. 27°)更高(P<0.05)。年轻组在前屈和外旋的平均改善程度也更大(P<0.05)。年轻组和老年组的并发症发生率、肩峰下切迹发生率和总体满意度率相似。

结论

65 岁及以下患者 RTSA 的患者报告结果评分和并发症发生率与 70 岁及以上患者相似。然而,年轻患者术后活动范围更大。

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