Desert Orthopedics at Eisenhower Medical Center, Rancho Mirage, CA, USA.
Colorado University Sports Medicine Center, Denver, CO, USA.
J Shoulder Elbow Surg. 2018 Jun;27(6S):S43-S49. doi: 10.1016/j.jse.2018.03.022.
This study evaluated how body mass index (BMI) factors into functional outcomes and complications after shoulder arthroplasty.
A retrospective analysis was performed of age-matched patients with a minimum 2-year follow-up after total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), or hemiarthroplasty (HA). Patient-reported outcome (PRO) scores, range of motion (ROM), and complications were assessed. Forty-nine patients were classified into the following groups: normal (BMI <24.9 kg/m), overweight (BMI 25-29.9 kg/m), class I obese (BMI 30-34.9 kg/m2), class II obese (BMI 35-39.9 kg/m), and class III morbid obese (BMI ≥40 kg/m).
A total of 245 patients (134 women, 111 men; average age, 64 ± 8 years) were evaluated at an average follow-up of 48 ± 18 months. TSA was performed in 122 patients (50%), RTSA was performed in 103 (42%), and HA was performed in 20 (8%). No significant difference was found among the 5 BMI groups in arthroplasty type (P = .108) or in complications, including reoperations (P = .27). All groups had significant postoperative improvements in PROs and ROM (P < .001 for both). There were no significant differences among the BMI groups in postoperative ROM or PROs.
This study demonstrates that patients undergoing TSA, RTSA, and HA can expect good functional outcomes, with improvements in pain, function and outcome scores, irrespective of BMI.
本研究评估了体重指数(BMI)因素对肩关节置换术后功能结果和并发症的影响。
对行全肩关节置换术(TSA)、反式全肩关节置换术(RTSA)或人工半肩关节置换术(HA)后至少随访 2 年的年龄匹配患者进行回顾性分析。评估患者报告的结果(PRO)评分、活动范围(ROM)和并发症。将 49 例患者分为以下几组:正常(BMI<24.9kg/m)、超重(BMI 25-29.9kg/m)、I 级肥胖(BMI 30-34.9kg/m2)、II 级肥胖(BMI 35-39.9kg/m)和 III 级病态肥胖(BMI≥40kg/m)。
共评估了 245 例患者(134 例女性,111 例男性;平均年龄 64±8 岁),平均随访 48±18 个月。122 例(50%)患者行 TSA,103 例(42%)行 RTSA,20 例(8%)行 HA。5 个 BMI 组之间在关节置换类型(P=0.108)或并发症(包括再手术,P=0.27)方面无显著差异。所有组在 PRO 和 ROM 术后均有显著改善(均 P<0.001)。BMI 组之间术后 ROM 或 PRO 无显著差异。
本研究表明,行 TSA、RTSA 和 HA 的患者无论 BMI 如何,均可获得良好的功能结果,疼痛、功能和结果评分均得到改善。