在平均5年的随访中，翻修性反肩关节置换术与初次反肩关节置换术的疗效相似。
Revision reverse shoulder arthroplasty has similar outcomes to primary reverse shoulder arthroplasty at 5 Year average follow-up.
作者信息
Hershey Maxwell L, Trenga Anthony P, Roge Seth A, Fisher Max R, Grindel Steven I
机构信息
Medical College of Wisconsin, Department of Orthopaedic Surgery, Milwaukee, WI, USA.
出版信息
J Orthop. 2023 Nov 4;46:150-155. doi: 10.1016/j.jor.2023.10.035. eCollection 2023 Dec.
BACKGROUND
Shoulder arthroplasty is a successful procedure that provides pain relief and improvements in function and range of motion. Anatomic and reverse shoulder arthroplasty are both effective procedures, and their indications continue to expand. We look at the outcomes of revision reverse total shoulder arthroplasty and compare it to the outcomes of primary reverse and anatomic total shoulder arthroplasty.
METHODS
We identified patients undergoing total shoulder arthroplasty at our institution between the years of 2010 and 2020. Data was prospectively collected and retrospectively reviewed for post-operative range of motion and strength in patients with revision surgery and compared to controls. Measurements were collected preoperatively and postoperatively including range of motion and strength in the affected and unaffected shoulder. We collected patient reported outcome measures in person and via phone to identify subjective outcomes of total shoulder arthroplasty. Average final follow-up was 5.27 years.
RESULTS
Our total patient sample was split between three groups: those with primary anatomic arthroplasty those who underwent primary reverse arthroplasty, and those who were revised to a reverse shoulder arthroplasty. All three groups had significant improvements in abduction and forward elevation from their pre-operative baseline to two years follow-up. Primary reverse had a significant improvement over revision reverse in abduction at one year follow-up. For all other range of motion measurements, there was no statistically significant difference at 2 years between primary and revision reverse shoulder arthroplasty. Patient reported outcomes had a significant increase from pre-op to most recent follow-up in all three groups.
CONCLUSION
Overall, our data suggest there is an improvement in outcomes with both primary and revision surgeries, and that results after revision reverse total shoulder arthroplasty may be comparable to primary reverse total shoulder arthroplasty.
背景
肩关节置换术是一种成功的手术，可缓解疼痛并改善功能和活动范围。解剖型和反置式肩关节置换术都是有效的手术方法，其适应证也在不断扩大。我们观察翻修反置式全肩关节置换术的结果，并将其与初次反置式和解剖型全肩关节置换术的结果进行比较。
方法
我们确定了2010年至2020年间在本机构接受全肩关节置换术的患者。前瞻性收集数据，并对接受翻修手术患者的术后活动范围和力量进行回顾性分析，并与对照组进行比较。术前和术后均进行测量，包括患侧和未患侧肩部的活动范围和力量。我们亲自和通过电话收集患者报告的结局指标，以确定全肩关节置换术的主观结果。平均最终随访时间为5.27年。
结果
我们的患者样本分为三组：接受初次解剖型置换术的患者、接受初次反置式置换术的患者以及接受翻修至反置式肩关节置换术的患者。从术前基线到两年随访，所有三组患者的外展和前屈均有显著改善。在一年随访时，初次反置式置换术在外展方面比翻修反置式置换术有显著改善。对于所有其他活动范围测量，初次和翻修反置式肩关节置换术在两年时无统计学显著差异。所有三组患者报告的结局从术前到最近一次随访均有显著改善。
结论
总体而言，我们的数据表明初次手术和翻修手术的结果均有改善，翻修反置式全肩关节置换术后的结果可能与初次反置式全肩关节置换术相当。
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