Ng Julia Poh Hwee, Tham Sherlyn Yen Yu, Kolla Saketh, Kwan Yiu Hin, Tan James Chung Hui, Teo Timothy Wei Wen, Wee Andy Teck Huat, Toon Dong Hao
Department of Orthopedic Surgery, Khoo Teck Puat Hospital, Singapore.
Clin Shoulder Elb. 2022 Sep;25(3):210-216. doi: 10.5397/cise.2022.00822. Epub 2022 Jul 18.
Reverse shoulder arthroplasty (RSA), first introduced as a management option for cuff tear arthropathy, is now an accepted treatment for complex proximal humeral fractures. Few studies have identified whether the outcomes of RSA for shoulder trauma are comparable to those of RSA for shoulder arthritis.
This is a retrospective, single-institution cohort study of all patients who underwent RSA at our institution between January 2013 and December 2019. In total, 49 patients met the inclusion criteria. As outcomes, we evaluated the 1-year American Shoulder and Elbow Surgeons (ASES) and Constant shoulder scores, postoperative shoulder range of motion, intra- and postoperative complications, and cumulative revision rate. The patients were grouped based on preoperative diagnosis to compare postoperative outcomes across two broad groups.
The median follow-up period was 32.8 months (interquartile range, 12.6-66.6 months). The 1-year visual analog scale, range of motion, and Constant and ASES functional scores were comparable between RSAs performed to treat shoulder trauma and that performed for arthritis. The overall complication rate was 20.4%, with patients with a preoperative diagnosis of arthritis having significantly more complications than those with a preoperative diagnosis of trauma (34.8% vs. 7.7%).
Patients who underwent RSA due to a proximal humeral fracture or dislocation did not fare worse than those who underwent RSA for arthritis at 1 year, in terms of both functional and radiological outcomes.
反向肩关节置换术(RSA)最初作为治疗肩袖撕裂性关节病的一种治疗选择被引入,现在已成为治疗复杂肱骨近端骨折的一种公认疗法。很少有研究确定RSA治疗肩部创伤的结果是否与RSA治疗肩部关节炎的结果相当。
这是一项对2013年1月至2019年12月期间在本机构接受RSA手术的所有患者进行的回顾性单机构队列研究。共有49例患者符合纳入标准。作为观察结果,我们评估了术后1年的美国肩肘外科医师学会(ASES)和康斯坦特肩关节评分、术后肩关节活动范围、术中和术后并发症以及累积翻修率。根据术前诊断对患者进行分组,以比较两个大组的术后结果。
中位随访期为32.8个月(四分位间距为12.6 - 66.6个月)。治疗肩部创伤的RSA手术与治疗关节炎的RSA手术相比,术后1年的视觉模拟评分、活动范围以及康斯坦特和ASES功能评分相当。总体并发症发生率为20.4%,术前诊断为关节炎的患者并发症明显多于术前诊断为创伤的患者(34.8%对7.7%)。
就功能和影像学结果而言,因肱骨近端骨折或脱位接受RSA手术的患者在术后1年的情况并不比因关节炎接受RSA手术的患者差。