Kusin David J, Ungar Joshua A, Samson Kaeli K, Teusink Matthew J
Department of Orthopedic Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
University of Nebraska College of Medicine, Omaha, NE, USA.
JSES Open Access. 2019 Sep 11;3(3):179-182. doi: 10.1016/j.jses.2019.07.001. eCollection 2019 Oct.
Dislocation of total shoulder arthroplasty has an incidence as high as 31%. Obesity is one of many proposed risk factors, but no consensus exists on this relationship. The purpose of this study was to determine whether there is a relationship between body mass index (BMI) and dislocation of total shoulder arthroplasty.
The National Surgical Quality Improvement Program database was used to identify patients older than 50 years who underwent anatomic or reverse total shoulder arthroplasty between the years 2012 and 2016 for primary or secondary osteoarthritis, post-traumatic arthritis, or cuff tear arthropathy. Patients requiring reoperation or readmission for dislocation were identified by Current Procedural Terminology code. The relationship between World Health Organization BMI classification and dislocation was assessed.
A total of 9382 patients were identified; 46% were male and 54% female, with an average age of 68.7 years (range 50-90) and average BMI of 31.2 (range 15.1-79.3). There were only 24 dislocation events within the first 30 days after the procedure (0.26%). Ten of 24 (42%) occurred after discharge. Seventy percent of cases (17 of 24) required an open procedure. Underweight patients (BMI < 18.5) experienced the highest dislocation rate (1/50, 2.00%), whereas overweight patients (BMI 25-29.9) experienced the lowest dislocation rate (3/3069, 0.1%).
The rate of dislocation of total shoulder arthroplasty in the acute postoperative period differs across categories of BMI. However, there does not appear to be a linear association between BMI and risk of dislocation of total shoulder arthroplasty. Further studies are required to elucidate the risk factors for total shoulder dislocation.
全肩关节置换术脱位的发生率高达31%。肥胖是众多被提出的风险因素之一，但关于这种关系尚无共识。本研究的目的是确定体重指数（BMI）与全肩关节置换术脱位之间是否存在关联。
利用国家外科质量改进计划数据库，识别2012年至2016年间因原发性或继发性骨关节炎、创伤后关节炎或肩袖撕裂性关节病接受解剖型或反置式全肩关节置换术的50岁以上患者。通过当前手术操作术语代码识别因脱位需要再次手术或再次入院的患者。评估世界卫生组织BMI分类与脱位之间的关系。
共识别出9382例患者；46%为男性，54%为女性，平均年龄68.7岁（范围50 - 90岁），平均BMI为31.2（范围15.1 - 79.3）。术后前30天内仅有24例脱位事件（0.26%）。24例中有10例（42%）发生在出院后。70%的病例（24例中的17例）需要开放手术。体重过轻的患者（BMI < 18.5）脱位率最高（1/50，2.00%），而超重患者（BMI 25 - 29.9）脱位率最低（3/3069，0.1%）。
全肩关节置换术急性术后脱位率在不同BMI类别中有所不同。然而，BMI与全肩关节置换术脱位风险之间似乎不存在线性关联。需要进一步研究以阐明全肩关节脱位的风险因素。
