Buchanan Timothy R, Hao Kevin A, Cueto Robert J, Bindi Victoria E, O'Keefe Daniel S, Hones Keegan M, Krisanda Emily K, Wright Jonathan O, Wright Thomas W, Farmer Kevin W, Struk Aimee M, Schoch Bradley S, King Joseph J
College of Medicine, University of Florida, Gainesville, FL, USA.
Department of Orthopaedic Surgery and Sports Medicine, University of Florida, Gainesville, FL, USA.
Shoulder Elbow. 2024 Jul 23:17585732241263753. doi: 10.1177/17585732241263753.
This study sought to characterize the tipping point values (the functional scores that patients deem dysfunctional enough to warrant surgery) for patients undergoing first revision reverse total shoulder arthroplasty (rTSA).
This study was a retrospective review of a prospectively collected single-institution database of patients undergoing first revision rTSA between August 2015 and December 2019. Tipping point evaluation utilized preoperative scores including the American Shoulder and Elbow Surgeons (ASES), raw and normalized Constant, Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST), and University of California-Los Angeles (UCLA) scores, and active range of motion including abduction, forward elevation (FE), external rotation (ER), and internal rotation score (IR) prior to elective revision rTSA.
We included 125 revision rTSAs. Tipping points were 37.6 ASES score, 30.5 raw Constant score, 35.5 normalized Constant score, 68.1 SPADI, 3.7 SST, 13.2 UCLA score, 64° abduction, 69° FE, 23° ER, and 3.1 IR. Higher SST was found for older patients and patients with a lower body mass index. Lower abduction and FE tipping points were reported in patients undergoing revision rTSA for rotator cuff failure, unexplained pain, and implant wear.
These tipping points can help surgeons counsel patients regarding when to undergo revision rTSA.
Level III; retrospective cohort study; treatment study.
本研究旨在确定初次翻修反向全肩关节置换术（rTSA）患者的临界点值（患者认为功能障碍严重到足以进行手术的功能评分）。
本研究是一项对前瞻性收集的单机构数据库的回顾性分析，该数据库包含2015年8月至2019年12月期间接受初次翻修rTSA的患者。临界点评估采用术前评分，包括美国肩肘外科医师学会（ASES）评分、原始和标准化的Constant评分、肩痛和功能障碍指数（SPADI）、简单肩关节测试（SST）以及加利福尼亚大学洛杉矶分校（UCLA）评分，以及择期翻修rTSA前的主动活动范围，包括外展、前屈（FE）、外旋（ER）和内旋评分（IR）。
我们纳入了125例翻修rTSA病例。临界点分别为ASES评分37.6、原始Constant评分30.5、标准化Constant评分35.5、SPADI评分68.1、SST评分3.7、UCLA评分13.2、外展64°、前屈69°、外旋23°和内旋评分3.1。老年患者和体重指数较低的患者SST较高。因肩袖损伤、不明原因疼痛和植入物磨损接受翻修rTSA的患者外展和前屈临界点较低。
这些临界点可帮助外科医生就何时进行翻修rTSA向患者提供咨询。
III级；回顾性队列研究；治疗研究。
