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解剖型全肩关节置换翻修为反式肩关节置换治疗肩袖撕裂或假体松动的患者结局:一项匹配队列研究。

Patient Outcomes After Revision of Anatomic Total Shoulder Arthroplasty to Reverse Shoulder Arthroplasty for Rotator Cuff Failure or Component Loosening: A Matched Cohort Study.

机构信息

From The Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI.

出版信息

J Am Acad Orthop Surg. 2019 Feb 15;27(4):e193-e198. doi: 10.5435/JAAOS-D-17-00350.

Abstract

PURPOSE

To compare outcomes after conversion of anatomic total shoulder arthroplasty (aTSA) to reverse total shoulder arthroplasty (RTSA) and a matched cohort.

METHODS

Patients converted from aTSA to RTSA for rotator cuff failure or component loosening and a primary RTSA matched cohort were retrospectively identified from a prospective database. Demographics and preoperative and postoperative outcomes were obtained and compared.

RESULTS

Age, sex, body mass index, follow-up length, and preoperative function were similar between revision (n = 35) and primary (n = 70) groups. At final follow-up, visual analog scale pain (2.4 ± 2.8 versus 1.7 ± 2.8; P = 0.24) and American Shoulder and Elbow Surgeons (68 ± 26 versus 76 ± 24; P = 0.14) scores were similar. The revision group had worse subjective shoulder value scores (63 ± 30 versus 79 ± 21; P = 0.002), satisfaction (74% versus 90%; P = 0.03), and more complications (31% versus 13%; P = 0.02).

CONCLUSION

Revision of aTSA to RTSA for component loosening or rotator cuff failure results in function comparable to primary RTSA; however, more complications, worse subjective shoulder value scores, and lower patient satisfaction should be expected.

LEVEL OF EVIDENCE

Level III, retrospective comparative.

摘要

目的

比较解剖全肩关节置换术(aTSA)翻修为反式全肩关节置换术(RTSA)与匹配队列的结果。

方法

从前瞻性数据库中回顾性地确定了因肩袖失败或组件松动而从 aTSA 翻修为 RTSA 的患者和一组原发性 RTSA 匹配队列。获取并比较了人口统计学资料以及术前和术后结果。

结果

在翻修组(n = 35)和原发性组(n = 70)之间,年龄、性别、体重指数、随访时间和术前功能相似。在最终随访时,视觉模拟评分疼痛(2.4 ± 2.8 与 1.7 ± 2.8;P = 0.24)和美国肩肘外科医师协会评分(68 ± 26 与 76 ± 24;P = 0.14)相似。翻修组的主观肩部值评分(63 ± 30 与 79 ± 21;P = 0.002)、满意度(74%与 90%;P = 0.03)和并发症更多(31%与 13%;P = 0.02)。

结论

因组件松动或肩袖失败而将 aTSA 翻修为 RTSA 可获得与原发性 RTSA 相当的功能;但是,应预期会出现更多的并发症,主观肩部值评分更差和患者满意度降低。

证据水平

III 级,回顾性比较。

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