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反式全肩关节置换术后的僵硬

Postoperative stiffness after reverse total shoulder arthroplasty.

作者信息

Ghoraishian Mohammad, Hill Brian W, Nicholson Thema, Ramsey Matthew L, Williams Gerald R, Namdari Surena

机构信息

Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.

出版信息

Shoulder Elbow. 2022 Apr;14(2):150-156. doi: 10.1177/1758573220967312. Epub 2020 Oct 25.

Abstract

PURPOSE

The purpose of this study was to evaluate the rate and risk factors for stiffness after reverse shoulder arthroplasty and the ramifications on the patient-reported outcomes.

METHOD

A consecutive series of patients who underwent reverse shoulder arthroplasty were prospectively followed for one year. Passive range of motion was measured preoperatively and at regular intervals postoperatively. Patients with passive forward elevation of less than 100° or passive external rotation of less than 30° were defined as stiff. Radiographic parameters and postoperative patient-reported outcome scores were collected.

RESULTS

Seventy-six patients were available for review. The prevalence of postoperative stiffness following reverse shoulder arthroplasty was 47% at three months, 31% at six months, and 25% at one year. Preoperative shoulder stiffness was associated with three-month postoperative stiffness only. In patients with one-year stiffness, smaller ( = 0.03) and less lateralized glenospheres ( = 0.024) were more common. Stiffness was not associated with one-year patient-reported outcome scores.

CONCLUSION

Stiffness is common after reverse shoulder arthroplasty and often improves at one-year after surgery. Implant design and selection may be important determinants of passive range of motion. While stiffness does not appear to influence patient-reported outcome scores, one of four patients will potentially have stiffness one year following reverse shoulder arthroplasty. Level III; retrospective study.

摘要

目的

本研究旨在评估反式肩关节置换术后僵硬的发生率、危险因素及其对患者报告结局的影响。

方法

对连续一系列接受反式肩关节置换术的患者进行为期一年的前瞻性随访。术前及术后定期测量被动活动范围。被动前屈小于100°或被动外旋小于30°的患者被定义为僵硬。收集影像学参数及术后患者报告的结局评分。

结果

76例患者可供评估。反式肩关节置换术后3个月僵硬的发生率为47%,6个月时为31%,1年时为25%。术前肩关节僵硬仅与术后3个月的僵硬相关。在术后1年出现僵硬的患者中,较小的(=0.03)和更偏向内侧的球盂假体(=0.024)更为常见。僵硬与术后1年患者报告的结局评分无关。

结论

反式肩关节置换术后僵硬很常见,且术后1年时通常会有所改善。植入物的设计和选择可能是被动活动范围的重要决定因素。虽然僵硬似乎不影响患者报告的结局评分,但四分之一的患者在反式肩关节置换术后1年可能会出现僵硬。三级;回顾性研究。

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