Altintas Burak, Horan Marilee P, Dornan Grant J, Pogorzelski Jonas, Godin Jonathan A, Millett Peter J
Steadman Philippon Research Institute, Vail, CO, USA.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
JSES Int. 2022 May 13;6(4):587-595. doi: 10.1016/j.jseint.2022.04.011. eCollection 2022 Jul.
Excellent results have been reported for anatomic total shoulder arthroplasty (TSA) for the treatment of primary glenohumeral osteoarthritis (GHOA). We aim to assess the recovery curve and longitudinal effects of time, age, sex, and glenoid morphology on patient-reported outcomes (PROs) after primary anatomic TSA for primary GHOA.
Patients who underwent primary anatomic TSA over 5 years ago were included: Short-Form 12 Physical Component Summary, American Shoulder and Elbow Surgeons scores, Quick Disabilities of the Arm Shoulder and Hand Score, Single Assessment Numeric Evaluation, and patient satisfaction were assessed. Linear mixed-effects models were used to model progression in PROs longitudinally. Unadjusted models and models controlling for sex and age were constructed.
Eighty-one patients (91 shoulders) were included. Significant improvements from the preoperative period to 1 year postoperatively in the median American Shoulder and Elbow Surgeons (48 to 93; < .001), Quick Disabilities of the Arm Shoulder and Hand Score (42 to 11; < .001), Single Assessment Numeric Evaluation (50 to 91; < .001), and Short-Form 12 Physical Component Summary (35 to 53; = .004) scores were noted. No significant decrease was observed for any of the outcome scores. Median satisfaction at the final follow-up was 10 out of 10. At 1, 2, 3, 4, 5, 6, and 7 years postoperatively, 77%, 64%, 79%, 57%, 86%, 56%, and 78% of patients, respectively, reported sports participation equal to or slightly below preinjury level. There was no association between the glenoid morphology and functional outcomes.
Patients undergoing anatomic TSA for primary GHOA showed excellent improvement in PROs and satisfaction in the first year, and these results were maintained postoperatively for a minimum of 5 years. Age- and sex-adjusted models or glenoid morphology did not substantially alter any trends in PROs postoperatively.
已有报道称解剖型全肩关节置换术（TSA）治疗原发性盂肱关节骨关节炎（GHOA）效果良好。我们旨在评估原发性解剖型TSA治疗原发性GHOA后，时间、年龄、性别和关节盂形态对患者报告结局（PROs）的恢复曲线及纵向影响。
纳入5年前接受原发性解剖型TSA的患者：评估简短健康调查问卷12项身体成分汇总得分、美国肩肘外科医师协会评分、手臂、肩部和手部快速残疾评分、单项评估数值评定法以及患者满意度。采用线性混合效应模型纵向模拟PROs的进展情况。构建未调整模型以及控制性别和年龄的模型。
纳入81例患者（91个肩关节）。美国肩肘外科医师协会评分中位数从术前到术后1年有显著改善（从48提高到93；P<0.001），手臂、肩部和手部快速残疾评分（从42降至11；P<0.001），单项评估数值评定法（从50提高到91；P<0.001），以及简短健康调查问卷12项身体成分汇总得分（从35提高到53；P=0.004）。未观察到任何结局评分有显著下降。末次随访时的满意度中位数为满分10分中的10分。术后1、2、3、4、5、6和7年，分别有77%、64%、79%、57%、86%、56%和78%的患者报告运动参与程度等于或略低于受伤前水平。关节盂形态与功能结局之间无关联。
接受原发性解剖型TSA治疗原发性GHOA的患者在第一年PROs和满意度有显著改善，且这些结果在术后至少5年得以维持。年龄和性别调整模型或关节盂形态并未实质性改变术后PROs的任何趋势。
