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反向全肩关节置换术后的运动参与情况

Sports Participation After Reverse Total Shoulder Replacement.

作者信息

Al Housni Hilal S A, Lam Patrick H, Latif Joseph W, Murrell George A C

机构信息

Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, Australia.

Orthopaedic Department, Suhar Hospital, Suhar, Oman.

出版信息

Orthop J Sports Med. 2022 Nov 21;10(11):23259671221136304. doi: 10.1177/23259671221136304. eCollection 2022 Nov.

Abstract

BACKGROUND

Reverse total shoulder replacement (RTSR) is becoming a popular and reliable treatment for rotator cuff arthropathy. However, little is known about the ability to participate in sports after surgery.

PURPOSE

To determine to what extent RTSR will allow patients to participate in sporting activities and identify the associated factors that could affect postoperative sports participation.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Data were collected prospectively from patients who underwent RTSR over a 10-year period from April 2009 to May 2019. Patients were assessed before surgery, at 6 months after surgery, and at the final follow-up. Patients were asked within a validated shoulder questionnaire to rank their current highest level of sports participation, overall shoulder status, frequency of pain, level of pain, and functional levels. Their shoulder range of motion and strength were assessed before surgery and at 6 months after surgery.

RESULTS

The study included 108 shoulders (106 patients). The mean age was 74 years (range, 51-88 years), with 44 men and 64 women. The mean follow-up was 4 years. Overall shoulder satisfaction, frequency and levels of pain, and shoulder function improved significantly at 6 months and 4 years ( < .0001). External rotation, abduction, and forward flexion range of motion improved significantly at 6 months ( < .05 for all). The strength of internal rotation, external rotation, abduction, and adduction improved significantly at 6 months ( < .001 for all). The rate of return to sports was 67% at 6 months and 48% at 4 years. Multiple significantly associated factors were identified with return to sports at 6 months, including sex and age.

CONCLUSION

The rate of return to sports after RTSR is high. Around two-thirds of patients can return to sports at 6 months postoperatively, although the results slightly deteriorate over time (48% at 4 years).

摘要

背景

反式全肩关节置换术(RTSR)正成为治疗肩袖关节病的一种流行且可靠的方法。然而,对于术后参与运动的能力了解甚少。

目的

确定RTSR能在多大程度上使患者参与体育活动,并识别可能影响术后运动参与的相关因素。

研究设计

病例系列;证据等级,4级。

方法

前瞻性收集2009年4月至2019年5月期间接受RTSR的患者的数据。在手术前、术后6个月和最终随访时对患者进行评估。在一份经过验证的肩部问卷中,询问患者对其当前最高运动参与水平、整体肩部状况、疼痛频率、疼痛程度和功能水平进行排名。在手术前和术后6个月评估他们的肩部活动范围和力量。

结果

该研究纳入了108个肩关节(106例患者)。平均年龄为74岁(范围51 - 88岁),其中男性44例,女性64例。平均随访时间为4年。整体肩部满意度、疼痛频率和程度以及肩部功能在6个月和4年时均有显著改善(P <.0001)。外旋、外展和前屈活动范围在6个月时显著改善(均P <.05)。内旋、外旋、外展和内收力量在6个月时显著改善(均P <.001)。6个月时恢复运动的比例为67%,4年时为48%。确定了多个与6个月时恢复运动显著相关的因素,包括性别和年龄。

结论

RTSR术后恢复运动的比例较高。大约三分之二的患者在术后6个月可以恢复运动,尽管随着时间推移结果略有下降(4年时为48%)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35c0/9706072/e3fcf2391bb5/10.1177_23259671221136304-fig1.jpg

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