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优化术后结果:借助舒尔特斯当地肩关节置换登记处的见解揭示患者报告结果的重要性。

Optimizing post-surgical outcomes: unveiling the importance of patient-reported outcomes with insights from the schulthess local shoulder arthroplasty registry.

作者信息

Asimina Lazaridou, Tim Schneller, Florian Freislederer, Philipp Moroder, Markus Scheibel

机构信息

Department for Shoulder and Elbow Surgery, Schulthess Clinic, Zürich, Switzerland.

Department of Anesthesiology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.

出版信息

BMC Musculoskelet Disord. 2024 Dec 19;25(1):1026. doi: 10.1186/s12891-024-08117-2.

Abstract

OBJECTIVE

The establishment of clinical registries is essential for the comprehensive evaluation of surgical outcomes. In 2006, the Schulthess Shoulder Arthroplasty Registry (SAR) was launched to systematically assess safety, implant longevity, functional outcomes, pain levels, quality of life, and patient satisfaction in individuals undergoing shoulder arthroplasty. This paper aims to outline the registry data and demonstrate how it is leveraged to improve clinical outcomes. Additionally, we provide guidance for organizations currently collecting or planning to collect similar data.

PARTICIPANTS

Our SAR systematically records adult patients' data undergoing either anatomic or reverse shoulder joint replacement at the Schulthess Clinic. Both primary and revision surgeries are comprehensively documented within the registry.

CURRENT OUTCOMES

From March 2006 to December 2023, the SAR included 98% of eligible operations. A total of 2301 patients were recruited, accounting for 3576 operations and 14,487 person-years of follow-up. At baseline, the mean age was 71 (range: 20-95), with 65% being female patients. The most prevalent indication was cuff tear arthropathy (46%), and the mean preoperative Constant Score was (31 ± 15). Notably, functional recovery peaked at 12 months postoperatively, displaying no clinically significant deterioration during the initial ten follow-up years in the overall cohort (including both primary arthroplasty and revisions). The registry has been instrumental in addressing various clinical and methodological inquiries, focusing particularly on comparing different implant configurations and surgical techniques to optimize functional recovery. Additionally, SAR data played a pivotal role in substantiating the clinical significance and reliability of radiological monitoring for cortical bone resorption, scapular notching, and glenoid component loosening.

摘要

目的

建立临床登记系统对于全面评估手术效果至关重要。2006年,舒尔特斯肩部置换登记系统(SAR)启动,旨在系统评估接受肩部置换术患者的安全性、植入物使用寿命、功能结果、疼痛程度、生活质量和患者满意度。本文旨在概述登记系统数据,并展示如何利用这些数据改善临床结果。此外,我们为目前正在收集或计划收集类似数据的组织提供指导。

参与者

我们的SAR系统记录了在舒尔特斯诊所接受解剖型或反式肩关节置换的成年患者的数据。登记系统全面记录了初次手术和翻修手术。

当前结果

从2006年3月到2023年12月,SAR纳入了98%的符合条件的手术。共招募了2301名患者,涉及3576例手术和14487人年的随访。基线时,平均年龄为71岁(范围:20 - 95岁),女性患者占65%。最常见的适应证是肩袖撕裂性关节病(46%),术前平均Constant评分是(31 ± 15)。值得注意的是,功能恢复在术后12个月达到峰值,在总体队列(包括初次置换和翻修)的最初十年随访期间没有出现临床显著恶化。该登记系统有助于解决各种临床和方法学问题,尤其专注于比较不同的植入物配置和手术技术以优化功能恢复。此外,SAR数据在证实皮质骨吸收、肩胛切迹和关节盂组件松动的放射学监测的临床意义和可靠性方面发挥了关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f352/11660693/d997ed4796ed/12891_2024_8117_Fig1_HTML.jpg

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