Sharma Sribava, Berger Peter Z, Fassihi Safa C, Gu Alex, Stadecker Monica, Tarawneh Omar H, Campbell Joshua C, Best Matthew J, McFarland Ed G, Srikumaran Uma
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Orthopaedic Surgery, George Washington University School of Medicine, Washington DC, USA.
Shoulder Elbow. 2024 Oct;16(5):501-506. doi: 10.1177/17585732231176269. Epub 2023 May 17.
Total shoulder arthroplasty (TSA) and reverse TSA (rTSA) are successful treatments for end-stage shoulder arthritis. However, it is unknown whether prior arthroscopy is associated with an increased risk for revision surgery. This study investigates if undergoing a shoulder arthroscopy in the year prior to primary arthroplasty increases risk of revision surgery within 2 years.
Patients who underwent TSA or rTSA between 2005 and 2017 were identified in a natinal claims database and stratified into two cohorts: (1) individuals with a history of shoulder arthroscopy prior to arthroplasty and (2) individuals with no documented history of arthroscopy prior to arthroplasty. These cohorts were propensity matched based on demographic and comorbidity factors. Univariate analysis was used to determine differences in revision rates, aseptic loosening, periprosthetic fracture, and infection between the two cohorts.
Seven hundred and eighty-eight patients were successfully matched from the two cohorts. Revision surgery (3.4% vs. 1.4%, p = 0.001) and aseptic loosening (2.2% vs. 0.8% p = 0.021) were significantly more common in the arthroscopy cohort. Periprosthetic fracture and periprosthetic infection were not found to be significantly different between cohorts.
Shoulder arthroscopy in the year prior to shoulder arthroplasty is associated with an increased risk of complications, including revision and aseptic loosening.
全肩关节置换术（TSA）和反式全肩关节置换术（rTSA）是终末期肩关节关节炎的成功治疗方法。然而，之前的关节镜检查是否会增加翻修手术的风险尚不清楚。本研究调查了在初次置换术前一年内接受肩关节镜检查是否会增加两年内翻修手术的风险。
在一个国家索赔数据库中识别出2005年至2017年间接受TSA或rTSA的患者，并将其分为两个队列：（1）置换术前有肩关节镜检查史的个体；（2）置换术前无关节镜检查记录史的个体。根据人口统计学和合并症因素对这些队列进行倾向匹配。采用单因素分析来确定两个队列在翻修率、无菌性松动、假体周围骨折和感染方面的差异。
两个队列成功匹配了788例患者。翻修手术（3.4%对1.4%，p = 0.001）和无菌性松动（2.2%对0.8%，p = 0.021）在关节镜检查队列中明显更常见。假体周围骨折和假体周围感染在队列之间未发现显著差异。
肩关节置换术前一年进行肩关节镜检查与并发症风险增加相关，包括翻修和无菌性松动。
