Hetto Pit, Wolf Matthias, Tsitlakidis Stefanos, Deisenhofer Julian, Bruckner Thomas, Spranz David, Mick Paul
Department of Orthopedic and Trauma Surgery, University of Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120, Heidelberg, Germany.
J Orthop. 2024 Nov 2;64:59-63. doi: 10.1016/j.jor.2024.10.052. eCollection 2025 Jun.
Total shoulder arthroplasty (TSA) is a successful treatment method for patients with end-stage glenohumeral osteoarthritis and different factors influencing the clinical outcome have been determined. However, the role of hand dominance on the postoperative clinical results and implant survival is not well analyzed. Hypothesis: Hand Dominance does not influence the outcome after TSA.
In this single center cohort study, 138 consecutive patients with primary Osteoarthritis (OA)were treated with a TSA and evaluated with a mean follow-up of 45 months (range 24-158 months). 62.32 % (86 patients) underwent TSA on the dominant side (DOM group) and 37.68 % (52 patients) on their non-dominant side (NON-DOM group). For clinical evaluation the adjusted Constant-Murley (CS) score, pain (Numeric analog scale (NAS)), subjective satisfaction and range of motion (ROM) were recorded. Furthermore, survivorship analysis was performed for the endpoint revision for any reason.
Both dominant (DOM) and non-dominant (NON-DOM) groups demonstrated significant improvement in all clinical outcomes from pre-to postoperative (p < 0.0001) with no between-group differences (p > 0.05). Implant survival was 98.8 % at 123 months (DOM) and 90 % at 158 months (NON-DOM) (p = 0.89).
Hand dominance did not influence postoperative outcomes, survivorship, or age at time of surgery. Patients can expect excellent results after TSA regardless of their predominant dexterity.
Retrospective cohort study, Level III.
全肩关节置换术（TSA）是终末期盂肱关节骨关节炎患者的一种成功治疗方法，并且已经确定了影响临床结果的不同因素。然而，手的优势对术后临床结果和植入物存活率的作用尚未得到充分分析。假设：手的优势不影响TSA术后的结果。
在这项单中心队列研究中，138例连续的原发性骨关节炎（OA）患者接受了TSA治疗，平均随访45个月（范围24 - 158个月）。62.32%（86例患者）在优势侧接受TSA（优势侧组），37.68%（52例患者）在非优势侧接受TSA（非优势侧组）。为了进行临床评估，记录了调整后的Constant-Murley（CS）评分、疼痛（数字模拟量表（NAS））、主观满意度和活动范围（ROM）。此外，对因任何原因进行的终点翻修进行了生存率分析。
优势侧（DOM）组和非优势侧（NON-DOM）组术后所有临床结果均较术前有显著改善（p < 0.0001），组间无差异（p > 0.05）。123个月时植入物存活率为98.8%（DOM组），158个月时为90%（NON-DOM组）（p = 0.89）。
手的优势不影响术后结果、生存率或手术时的年龄。无论患者的主要灵巧程度如何，TSA术后均可获得良好结果。
回顾性队列研究，III级。
