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术前和术后肩胛盂后倾会影响反式全肩关节置换术后的疗效吗?

Do Preoperative and Postoperative Glenoid Retroversion Influence Outcomes After Reverse Total Shoulder Arthroplasty?

作者信息

Lansdown Drew, Cheung Edward C, Xiao Weiyuan, Lee Austin, Zhang Alan L, Feeley Brian T, Benjamin Ma C

机构信息

Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California.

出版信息

J Shoulder Elb Arthroplast. 2020 Apr 14;4:2471549220912552. doi: 10.1177/2471549220912552. eCollection 2020.

Abstract

BACKGROUND

There are limited data on the effect of glenoid retroversion in clinical outcomes following reverse total shoulder arthroplasty (RTSA). The purpose of this study was to evaluate if surgical correction of retroversion affects outcomes following RTSA.

METHODS

An institutional database was utilized to identify 177 patients (mean age: 68.2 ± 10.1 years) with minimum 2-year follow-up after primary RTSA. Glenoid version was measured on preoperative and postoperative radiographs. American Shoulder and Elbow Surgeons (ASES) scores and range of motion were collected before and after RTSA. Change in retroversion was determined by comparing preoperative and postoperative glenoid retroversion on radiographs using paired Wilcoxon signed-rank test. Spearman's rank correlation was used to investigate relationships between ASES scores and glenoid retroversion.

RESULTS

The mean postoperative ASES composite score (75.5 ± 22.7) was significantly higher than preoperative (36.8 ± 19.2;  < .0001). The mean preoperative glenoid retroversion was 9.1 ± 6.7° compared to 6.5 ± 5.1° postoperatively ( < .0001). There was no correlation between postoperative ASES scores and preoperative retroversion ( = .014,  = .85) or postoperative retroversion ( = -.043,  = .57). There was no statistical relationship between postoperative retroversion and range of motion, though there is a risk of inadequate power given the sample size.

CONCLUSIONS

Patient-reported outcomes and range of motion measurements following RTSA at short-term follow-up appear to be independent of either preoperative or postoperative glenoid retroversion.

摘要

背景

关于关节盂后倾对反式全肩关节置换术(RTSA)临床疗效影响的数据有限。本研究的目的是评估关节盂后倾的手术矫正是否会影响RTSA后的疗效。

方法

利用机构数据库确定177例初次RTSA术后至少随访2年的患者(平均年龄:68.2±10.1岁)。在术前和术后X线片上测量关节盂角度。收集RTSA前后的美国肩肘外科医师(ASES)评分和活动范围。通过使用配对Wilcoxon符号秩检验比较术前和术后X线片上的关节盂后倾情况来确定后倾的变化。采用Spearman秩相关分析来研究ASES评分与关节盂后倾之间的关系。

结果

术后ASES综合评分均值(75.5±22.7)显著高于术前(36.8±19.2;P<0.0001)。术前关节盂平均后倾角度为9.1±6.7°,术后为6.5±5.1°(P<0.0001)。术后ASES评分与术前的后倾角度(r=0.014,P=0.85)或术后的后倾角度(r=-0.043,P=0.57)均无相关性。术后后倾角度与活动范围之间无统计学关系,不过鉴于样本量,存在检验效能不足的风险。

结论

在短期随访中,RTSA后患者报告的疗效和活动范围测量结果似乎与术前或术后关节盂后倾无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e733/8282142/92aa279a5ed3/10.1177_2471549220912552-fig1.jpg

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