From The Department of Orthopaedic Surgery, Beaumont Health, Royal Oak, MI.
J Am Acad Orthop Surg. 2019 Feb 15;27(4):e193-e198. doi: 10.5435/JAAOS-D-17-00350.
To compare outcomes after conversion of anatomic total shoulder arthroplasty (aTSA) to reverse total shoulder arthroplasty (RTSA) and a matched cohort.
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.
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).
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 III, retrospective comparative.
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。
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。
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)。
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。
III 级,回顾性比较。