Allen William E, Lin Jackie J, Barfield William B, Friedman Richard J, Eichinger Josef K
Medical University of South Carolina, Charleston, SC, USA.
JSES Int. 2020 Jun 27;4(3):438-442. doi: 10.1016/j.jseint.2020.04.004. eCollection 2020 Sep.
Higher complication rates are reported after shoulder arthroplasty in obese patients. Understanding the effect of body mass index (BMI) on range of motion (ROM) in asymptomatic shoulders may be useful in evaluating clinical outcomes for patients of varying BMIs presenting with shoulder pathology. The purpose of this study is to investigate patient characteristics, in particular BMI, that may affect ROM outcomes after shoulder arthroplasty.
Individuals aged 18 years or older (mean 57.21 ± 16.27 years) were recruited with asymptomatic shoulder presentation and without history of shoulder injury. A total of 224 shoulders were grouped into 4 BMI categories, and ROM was measured with a goniometer. Analysis was performed between patient demographics and ROM.
Analyzed continuously, BMI negatively correlated with ROM for internal rotation (IR; = -0.511, < .01), forward elevation (FE; = -0.418, < .01), and external rotation (ER; = -0.328, < .01). ROM analyzed by BMI category revealed a dose effect of BMI vs ROM. Obese patients demonstrated a significant decrease in IR whereas morbidly obese patients had significant decreases for all ranges: IR ( = -0.469, < .01), FE ( = -0.452, < .01), and ER ( = -0.33, < .01). Normal- and overweight patients revealed no significant correlations with ROM.
As BMI is negatively correlated with ROM of the asymptomatic shoulder, patients with higher BMIs may be predisposed to diminished outcomes postoperatively. These baseline correlations will allow surgeons to make postoperative expectations and anticipate poorer outcomes of shoulder ROM in obese patients.
据报道,肥胖患者肩关节置换术后并发症发生率较高。了解体重指数(BMI)对无症状肩关节活动范围(ROM)的影响,可能有助于评估不同BMI的肩部疾病患者的临床结局。本研究的目的是调查可能影响肩关节置换术后ROM结局的患者特征,尤其是BMI。
招募年龄在18岁及以上(平均57.21±16.27岁)、肩关节无症状且无肩部损伤史的个体。将总共224个肩关节分为4个BMI类别,并用角度计测量ROM。对患者人口统计学特征和ROM进行分析。
连续分析显示,BMI与内旋(IR;r = -0.511,P <.01)、前屈(FE;r = -0.418,P <.01)和外旋(ER;r = -0.328,P <.01)的ROM呈负相关。按BMI类别分析的ROM显示BMI与ROM之间存在剂量效应。肥胖患者的IR显著降低,而病态肥胖患者在所有活动范围内均显著降低:IR(r = -0.469,P <.01)、FE(r = -0.452,P <.01)和ER(r = -0.33,P <.01)。正常体重和超重患者的ROM无显著相关性。
由于BMI与无症状肩关节的ROM呈负相关,BMI较高的患者术后可能易出现较差的结局。这些基线相关性将使外科医生能够做出术后预期,并预测肥胖患者肩部ROM的较差结局。