Lee Seungha, Kim Du-Han, Kim Soon Gu, Cho Chul-Hyun
Department of Orthopedic Surgery, Ulsan City Hospital, Ulsan, Republic of Korea.
Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea.
J Shoulder Elbow Surg. 2023 Jan;32(1):1-8. doi: 10.1016/j.jse.2022.08.026. Epub 2022 Oct 4.
The purpose of this study was to investigate sequential changes of emotional status and quality of life after reverse shoulder arthroplasty (RSA) for rotator cuff insufficiency and to determine the predictors that can affect postoperative clinical outcomes. This study was conducted to prove the hypothesis that RSA would improve emotional status and quality of life.
Fifty patients undergoing RSA for rotator cuff insufficiency were prospectively included. Evaluation using the visual analog scale pain score, American Shoulder and Elbow Surgeons (ASES) score, subjective shoulder value, Hospital Anxiety and Depression Scale (HADS), and Abbreviated scale of World Health Organization Quality of Life (WHOQOL-BREF) was performed before surgery and at 1.5, 3, 6, and 12 months after surgery.
The mean visual analog scale pain score, HADS-depression score, and HADS-anxiety score showed a significant decrease from 6.6, 13.3, and 13.9 before surgery to 1.5, 3.9, and 3.7 after 12 months after surgery, respectively (all P < .001). The mean ASES score, WHOQOL-BREF score, and subjective shoulder value showed a significant improvement from 28.5, 32.3, and 23.6% to 81.3, 79.1, and 78.4%, respectively (all P < .001). All outcome measurements showed a significant improvement from 6 weeks after RSA. In multivariate analysis, age was an independent predictor of the final ASES score and WHOQOL-BREF score (P = .037 and .004, respectively).
This study showed a sequential improvement of emotional status and quality of life as well as functional recovery with pain relief from 6 weeks after RSA in patients with rotator cuff insufficiency. Especially, younger patients had better postoperative functional ability and quality of life. These findings suggest that RSA for rotator cuff insufficiency provides a rapid improvement of emotional status and quality of life.
本研究旨在调查因肩袖功能不全而行反式肩关节置换术（RSA）后情绪状态和生活质量的序贯变化，并确定可影响术后临床结局的预测因素。本研究旨在验证RSA可改善情绪状态和生活质量这一假设。
前瞻性纳入50例因肩袖功能不全而行RSA的患者。在手术前以及术后1.5、3、6和12个月，使用视觉模拟量表疼痛评分、美国肩肘外科医师学会（ASES）评分、主观肩关节评分、医院焦虑抑郁量表（HADS）和世界卫生组织生活质量简表（WHOQOL-BREF）进行评估。
视觉模拟量表平均疼痛评分、HADS抑郁评分和HADS焦虑评分分别从术前的6.6、13.3和13.9显著下降至术后12个月时的1.5、3.9和3.7（均P <.001）。ASES平均评分、WHOQOL-BREF评分和主观肩关节评分分别从28.5、32.3和23.6%显著提高至81.3、79.1和78.4%（均P <.001）。所有结局指标在RSA术后6周均显示出显著改善。在多变量分析中，年龄是最终ASES评分和WHOQOL-BREF评分的独立预测因素（分别为P = 0.037和0.004）。
本研究表明，肩袖功能不全患者在RSA术后6周开始，情绪状态、生活质量以及功能恢复均有序贯改善，疼痛缓解。特别是，年轻患者术后功能能力和生活质量更好。这些发现表明，针对肩袖功能不全的RSA可快速改善情绪状态和生活质量。
