Li Troy, Duey Akiro H, White Christopher A, Pujari Amit, Patel Akshar V, Zaidat Bashar, Williams Christine S, Williams Alexis, Cirino Carl M, Shukla Dave, Parsons Bradford O, Flatow Evan L, Cagle Paul J
Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Clin Shoulder Elb. 2023 Sep;26(3):231-237. doi: 10.5397/cise.2023.00409. Epub 2023 Aug 11.
In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA.
Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival.
At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure.
When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.
在过去十年中,解剖型全肩关节置换术(aTSA)的手术数量稳步增加。65岁以上的患者占接受手术者的绝大多数,且手术效果已有充分记录;然而,越来越多年轻患者选择接受确定性手术治疗。我们旨在报告年龄对aTSA术后长期临床疗效的影响。
回顾性分析119例接受TSA手术患者的肩部情况。收集术前和术后临床疗效数据。进行线性回归分析(单变量和多变量)以评估临床疗效与年龄之间的关联。采用Kaplan-Meier曲线和Cox回归分析评估植入物生存率。
在末次随访时,与术前相比,所有接受aTSA手术的患者在所有主要疗效指标上均有显著且持续的改善。多变量分析显示,手术时的年龄是术后疗效的重要预测因素。在本研究过程中观察到植入物生存率良好,Cox回归生存分析表明年龄和性别与植入物失败风险增加无关。
在控制性别和随访时间的情况下,年龄较大与患者报告的疗效显著更好相关。尽管存在这种差异,但我们注意到年龄对活动范围或植入物生存率没有显著影响。证据等级:IV级。