双侧全肩关节置换术：临床结果的系统评价
Bilateral total shoulder arthroplasty: A systematic review of clinical outcomes.
作者信息
Smith John-Rudolph H, Houck Darby A, Hart Jessica A, Bravman Jonathan T, Frank Rachel M, Vidal Armando F, McCarty Eric C
机构信息
Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.
The Steadman Clinic, Vail, CO, USA.
出版信息
Shoulder Elbow. 2021 Aug;13(4):402-415. doi: 10.1177/1758573220916822. Epub 2020 Apr 19.
BACKGROUND
The purpose of this study was to describe the clinical outcomes following bilateral total shoulder arthroplasty (TSA).
METHODS
A systematic search of the PubMed, Embase, and Cochrane Library databases following PRISMA guidelines was performed. English-language literature published from 2010 to 2018 analyzing bilateral TSA (anatomic and/or reverse) with a minimum one-year follow-up was reviewed by two independent reviewers. Study quality was evaluated with the Modified Coleman Methodology Score and the methodological index for non-randomized studies score.
RESULTS
Eleven studies (1 Level II, 3 Level III, 7 Level IV) with 292 patients were included. Two studies reported on bilateral anatomic TSA ( = 54), six reported on bilateral reverse TSA (RTSA; = 168), two reported on anatomic TSA with contralateral RTSA (TSA/RTSA; = 31), and one compared bilateral anatomic TSA ( = 26) and bilateral RTSA ( = 13). Among studies, mean revision rate ranged from 0% to 10.53% and mean complication rate ranged from 4.9% to 31.3%. At final follow-up, patients experienced significant overall improvements in range of motion and patient-reported outcome score measurements. However, bilateral anatomic TSA resulted in greater improvements in external rotation compared to bilateral RTSA. Overall patient satisfaction was 91.0%.
CONCLUSION
The available data indicate that bilateral TSA allows for functional and pain improvements and result in high patient satisfaction.
LEVEL OF EVIDENCE
IV.
背景
本研究旨在描述双侧全肩关节置换术（TSA）后的临床结果。
方法
按照PRISMA指南对PubMed、Embase和Cochrane图书馆数据库进行系统检索。两名独立评审员对2010年至2018年发表的分析双侧TSA（解剖型和/或反向型）且至少随访一年的英文文献进行了综述。采用改良科尔曼方法评分和非随机研究方法指数评分对研究质量进行评估。
结果
纳入11项研究（1项II级、3项III级、7项IV级），共292例患者。两项研究报告了双侧解剖型TSA（n = 54），六项报告了双侧反向TSA（RTSA；n = 168），两项报告了解剖型TSA与对侧RTSA（TSA/RTSA；n = 31），一项比较了双侧解剖型TSA（n = 26）和双侧RTSA（n = 13）。在各项研究中，平均翻修率为0%至10.53%，平均并发症发生率为4.9%至31.3%。在末次随访时，患者的活动范围和患者报告的结局评分测量结果总体有显著改善。然而，与双侧RTSA相比，双侧解剖型TSA在外旋方面的改善更大。患者总体满意度为91.0%。
结论
现有数据表明，双侧TSA可改善功能和减轻疼痛，并使患者满意度较高。
证据等级
IV级。
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