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反向全肩关节置换术的临床及功能结果与术后康复方案

Clinical and Functional Results of Reverse Total Shoulder Arthroplasty and Postoperative Rehabilitation Protocol.

作者信息

Pereira Vitor C, Barreto José, Tomé Sónia, Cunha João, Amaro João, Moreira Jorge, Miranda António, Branco Catarina A

机构信息

Department of Physical Medicine and Rehabilitation, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PRT.

Department of Physical Medicine and Rehabilitation, Hospital da Senhora da Oliveira Guimarães, Guimarães, PRT.

出版信息

Cureus. 2022 Mar 19;14(3):e23322. doi: 10.7759/cureus.23322. eCollection 2022 Mar.

Abstract

Purpose This retrospective study aims to analyze the clinical and functional results obtained over a seven-year period of performing reverse total shoulder arthroplasty (RTSA) and the subsequent postoperative rehabilitation protocol. Methods We analyzed data from 80 patients who were evaluated at a preoperative, as well as monthly postoperative outpatient consultation, until the discharge from the rehabilitation program, using Constant Score (CS). Results A comparison of preoperative and postoperative (after rehabilitation protocol) results revealed an improved functional score of absolute CS (20.8 increase), normal relative CS (29.1 increase), and individual relative CS (31.7 increase) with statistical significance (p<0.05). From the analysis of CS subscores, there was a positive evolution of the pain subscore, as well as flexion, abduction, and external rotation combined with abduction range of motion (ROM). Contrarily, there was a negative evolution of the combined internal rotation, extension, and adduction ROM, as well as deltoid muscle strength. No statistically significant correlations were found between age and postoperative CS, as well as between the time interval from surgery to the beginning of outpatient rehabilitation and CS evolution. Conclusion Our study demonstrates that RTSA is an effective therapeutic option that, if combined with a well-structured rehabilitation program, can improve pain, mobility, and upper limb functionality.

摘要

目的 本回顾性研究旨在分析在七年时间里进行反向全肩关节置换术(RTSA)所取得的临床和功能结果以及随后的术后康复方案。方法 我们使用Constant评分(CS)分析了80例患者的数据,这些患者在术前以及术后每月门诊复诊时均接受评估,直至康复计划结束出院。结果 术前和术后(康复方案实施后)结果的比较显示,绝对CS功能评分提高(增加20.8),相对CS正常评分提高(增加29.1),个体相对CS评分提高(增加31.7),具有统计学意义(p<0.05)。通过对CS子评分的分析,疼痛子评分以及屈曲、外展和外旋合并外展活动范围(ROM)有正向变化。相反,内旋、伸展和内收ROM合并三角肌力量有负向变化。在年龄与术后CS之间以及从手术到门诊康复开始的时间间隔与CS变化之间未发现统计学上的显著相关性。结论 我们的研究表明,RTSA是一种有效的治疗选择,如果与精心制定的康复计划相结合,可以改善疼痛、活动能力和上肢功能。

相似文献

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Accelerated rehabilitation following reverse total shoulder arthroplasty.反式全肩关节置换术后的加速康复。
J Shoulder Elbow Surg. 2021 Sep;30(9):e545-e557. doi: 10.1016/j.jse.2020.11.017. Epub 2021 Jan 5.

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