Schroen Christoph A, Ranson William A, Singh Priya, Li Troy, Patel Akshar V, Bernstein Jordan, Shukla Dave R, Parsons Bradford O, Flatow Evan L, Cagle Paul J
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Orthop. 2024 Dec 15;65:57-63. doi: 10.1016/j.jor.2024.12.010. eCollection 2025 Jul.
Anatomic total shoulder arthroplasty (aTSA) is often delayed due to concerns about a more rapid loss of postoperative improvements in younger, more active patients. This retrospective study investigated the effects of patient age on activity-specific functional outcomes at a minimum of 10 years following aTSA.
A retrospective review of a shoulder arthroplasty database was performed. There were two cohorts: Patients who underwent aTSA at 60-70 years of age and patients 70+ years old with Minimum 10 years follow-up. Primary outcomes included range of motion (ROM) and patient reported outcomes (PROs) including American Shoulder and Elbow Surgeons (ASES), Simple Shoulder Test (SST), and Visual Analogue Scale (VAS) scores. Furthermore, individual survey responses to the ASES Score questionnaire were analyzed.
46 shoulders, 30 shoulders in the 60-70 age cohort and 16 in the 70+ cohort, were included with a mean age of 65.5 ± 3.0 years and 74.2 ± 3.2 years, respectively. Interval from surgery was 15.6 ± 3.9 years in the 60-70 cohort, and 13.1 ± 3.2 years in the 70+ cohort. Postoperatively, scores for the 60-70 cohort versus 70+ respectively included: 141.7° versus 153.1° forward elevation (p = 0.12), 52.4° versus 51.3° external rotation (p = 0.82), L1 versus T11 internal rotation (p = 0.12), 2.1 versus 2.1 VAS (p = 0.94), 75.7 versus 73.8 ASES (p = 0.79), and 7.8 versus 8.8 SST (p = 0.35). Postoperative scores were similar between cohorts. No difference was seen in preoperative responses for any activity listed in the ASES-score questionnaire. However, younger patients showed improvement across all survey responses, while patients above age 70 had long-term improvement in only 5 of 10 activities.
Patients who receive surgery earlier may experience sustained improvement long-term, same as those who undergo aTSA at an older age. Patients undergoing aTSA earlier in life benefit from sustained long-term function and activity.
由于担心年轻、活动量较大的患者术后改善效果丧失更快，解剖型全肩关节置换术（aTSA）常常被推迟。这项回顾性研究调查了患者年龄对aTSA术后至少10年特定活动功能结局的影响。
对一个肩关节置换术数据库进行回顾性分析。有两个队列：60至70岁接受aTSA的患者和70岁及以上的患者，随访时间至少10年。主要结局包括活动范围（ROM）和患者报告结局（PROs），包括美国肩肘外科医师学会（ASES）评分、简易肩关节测试（SST）和视觉模拟量表（VAS）评分。此外，还分析了对ASES评分问卷的个体调查回复。
共纳入46例肩部病例，60至70岁年龄队列中有30例，70岁及以上队列中有16例，平均年龄分别为65.5±3.0岁和74.2±3.2岁。60至70岁队列的手术间隔时间为15.6±3.9年，70岁及以上队列的手术间隔时间为13.1±3.2年。术后，60至70岁队列与70岁及以上队列的评分分别为：前屈上举角度141.7°对153.1°（p = 0.12），外旋角度52.4°对51.3°（p = 0.82），内旋角度L1对T11（p = 0.12），VAS评分2.1对2.1（p = 0.94），ASES评分75.7对73.8（p = 0.79），SST评分7.8对8.8（p = 0.35）。各队列术后评分相似。在ASES评分问卷中列出的任何活动的术前回复中未发现差异。然而，年轻患者在所有调查回复中均有改善，而70岁以上患者仅在十项活动中的五项中有长期改善。
早期接受手术的患者可能与老年接受aTSA的患者一样，长期经历持续改善。年轻时接受aTSA的患者受益于持续的长期功能和活动。
3级。
