Sheth Mihir M, Schiffman Corey J, Whitson Anastasia J, Matsen Frederick A, Hsu Jason E
Department of Orthopedics and Sports Medicine, Investigation Performed at the University of Washington, 1959 NE Pacific Street, Box 356500, Seattle, WA, USA.
Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, 1959 NE Pacific Street, Box 356500, Seattle, WA, 98195-6500, USA.
Int Orthop. 2025 May;49(5):1119-1125. doi: 10.1007/s00264-024-06373-4. Epub 2024 Nov 29.
While bone grafting and augmented components can help restore reverse shoulder arthroplasty (RSA) baseplate version close to neutral, the indication for version correction in RSA is unclear. The purpose of this study was to compare the clinical outcomes of RSA baseplates in high degrees of retroversion and anteversion to components in more neutral version.
Patients who underwent RSA with minimum two year follow-up were identified from an institutional registry. An RSA system with a glenosphere that is two-thirds of a sphere was utilized. Post-operative radiographs were used to determine baseplate version, and patients were grouped into four categories: ≥ 10 degrees (moderate to severe anteversion; n = 14), 10 to -10 degrees (neutral; n = 69), -10 to -20 (moderate retroversion; n = 25), and ≤ -20 degrees (severe retroversion; n = 7). The outcomes of interest were ability to perform functions requiring internal rotation, external rotation and cross-body adduction, as well as complications and revisions.
There were no differences in final Simple Shoulder Test (SST), final American Shoulder and Elbow Surgeons score (ASES) or change in SST from pre- to post-operative across the four version groups. There was no linear correlation between baseplate version and final SST. There were no statistically significant differences in difficulty performing tasks related to internal rotation, external rotation, and cross-body adduction among the four baseplate version groups; however, patients with moderate to severe anteversion had a greater frequency of difficulty putting on a coat (86%) compared to patients with neutral version (42%), moderate retroversion (45%) and severe retroversion (0%) (p = 0.021). There were no differences in rates of complications and revisions across the four groups.
This study did not find evidence that high values of baseplate retroversion or anteversion were associated with inferior patient reported outcomes or functional rotation after reverse total shoulder arthroplasty.
Level 3, retrospective comparative study.
虽然骨移植和增强型组件有助于将反肩关节置换术（RSA）基板的版本恢复到接近中立状态，但RSA中版本校正的指征尚不清楚。本研究的目的是比较高度后倾和前倾的RSA基板与更中立版本组件的临床结果。
从机构登记处识别出接受RSA且随访至少两年的患者。使用了一种球头为球体三分之二的RSA系统。术后X线片用于确定基板版本，患者分为四类：≥10度（中度至重度前倾；n = 14）、10至 -10度（中立；n = 69）、-10至 -20度（中度后倾；n = 25）和≤ -20度（重度后倾；n = 7）。感兴趣的结果是执行需要内旋、外旋和体侧内收功能的能力，以及并发症和翻修情况。
在四个版本组中，最终简易肩关节测试（SST）、最终美国肩肘外科医生评分（ASES）或术前到术后SST的变化没有差异。基板版本与最终SST之间没有线性相关性。四个基板版本组在执行与内旋、外旋和体侧内收相关任务的难度上没有统计学显著差异；然而，与中立版本（42%）、中度后倾（45%）和重度后倾（0%）的患者相比，中度至重度前倾的患者穿外套困难的频率更高（86%）（p = 0.021）。四组之间的并发症和翻修率没有差异。
本研究没有发现证据表明RSA后基板后倾或前倾值较高与患者报告的较差结果或功能旋转有关。
3级，回顾性比较研究。
