Matthews Christopher J, Wright Thomas W, Farmer Kevin W, Struk Aimee M, Vasilopoulos Terrie, King Joseph J
Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.
Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.
J Hand Surg Am. 2019 Feb;44(2):104-111. doi: 10.1016/j.jhsa.2018.11.008.
We compare clinical outcomes of primary reverse total shoulder arthroplasty (RTSA) in patients 65 years old or younger with a matched control group of patients 70 years old or older.
Forty-three patients (17 men and 26 women) 65 years old or younger were retrospectively identified. The mean age was 60 years and average follow-up was 4.0 years. The most common surgical indication was rotator cuff arthropathy. Patients were sex- and diagnosis-matched to control patients 70 years old or older with a mean follow-up of 4.1 years. Active range of motion (ROM) and functional outcomes in the 2 groups were evaluated before and after surgery.
Patients 65 years old or younger had significantly lower preoperative functional scores; preoperative ROM, however, was similar in the 2 groups. Both groups significantly improved in postoperative ROM and functional scores (with no difference in Shoulder Pain and Disability Index [SPADI]-130, Simple Shoulder Test [SST], University of California-Los Angeles [UCLA], and Constant scores); however, the younger cohort had lower functional scores; American Shoulder and Elbow Surgeons (ASES) and 12-Item Short Form Health Survey (SF-12) were significantly lower after surgery. The change in ROM and outcome measures before to after surgery was similar between groups. Similar complications and notching rates were seen between the groups at final follow-up.
An RTSA in patients 65 years old or younger improves ROM comparably with patients 70 years old or older. Younger patients have lower functional scores before and after surgery. An RTSA in younger patients improves pain and function but is associated with worse perceived outcomes.
Therapeutic III.
我们比较65岁及以下患者行初次翻修全肩关节置换术（RTSA）与70岁及以上匹配对照组患者的临床结果。
回顾性纳入43例65岁及以下患者（17例男性和26例女性）。平均年龄为60岁，平均随访时间为4.0年。最常见的手术指征是肩袖关节病。将患者按性别和诊断与70岁及以上的对照患者进行匹配，平均随访时间为4.1年。评估两组患者手术前后的主动活动范围（ROM）和功能结果。
65岁及以下患者术前功能评分显著较低；然而，两组术前的ROM相似。两组术后的ROM和功能评分均显著改善（肩痛与功能障碍指数[SPADI]-130、简易肩关节测试[SST]、加利福尼亚大学洛杉矶分校[UCLA]和常数评分无差异）；然而，较年轻队列的功能评分较低；美国肩肘外科医师学会（ASES）和12项简短健康调查（SF-12）在术后显著较低。两组手术前后ROM和结果指标的变化相似。在最终随访时，两组的并发症和开槽率相似。
65岁及以下患者行RTSA与70岁及以上患者相比，ROM改善程度相当。较年轻患者手术前后的功能评分较低。较年轻患者行RTSA可改善疼痛和功能，但与较差的感知结果相关。
治疗性III级。
