Allio Noémie, Amouyel Thomas, Saab Marc, Chantelot Christophe
CHU Lille Hôpital Roger Salengro, Lille, Nord (59), France.
Université Médecine Lille Henri Warembourg, Lille, Nord (59), France.
Eur J Orthop Surg Traumatol. 2025 Mar 19;35(1):125. doi: 10.1007/s00590-025-04227-2.
While tuberosity reinsertion significantly improves the short-term functional outcomes of reverse shoulder arthroplasty done for proximal humerus fracture, we do not know how well these results hold over the long term. The objective of this study was to analyze the effect of tuberosity reinsertion on the quality of life of patients and the functional outcomes of the operated limb after a minimum follow-up of 5 years.
Sixty-two patients were included. Their mean age at the final review was 79 ± 10 years. The Katz and Lawton scales, Constant score, DASH and SSV were collected. Radiographs were made at the final assessment to analyze the position of the tuberosities and to look for radiological signs of implant loosening.
The mean follow-up was 6.7 ± 1.5 years. The tuberosities had been reinserted in 35 patients (56%). There were no statistically significant differences between groups in the Katz (p = 0.60) and Lawton (p = 0.49) scales, nor the DASH (p = 0.45) or SSV (p = 0.49) at the final review. The Constant score was significantly better in the patients who had their tuberosities reinserted (p = 0.01), also the active forward flexion (p = 0.02), the internal rotation (p = 0.01), and the external rotation arm abduction (p = 0.02), but there was no significant difference for external rotation elbow at side (p = 0.14). None of the patients underwent revision surgery for implant loosening.
Tuberosity reinsertion has a functional benefit beyond 5 years postoperative, although it does not appear to have a significant effect on the geriatric outcomes or the subjective clinical scores. The patients regained satisfactory independence for an orthogeriatric population.
Level IV-Retrospective study.
虽然结节重新植入能显著改善因肱骨近端骨折而行反肩关节置换术的短期功能结局，但我们并不清楚这些结果在长期内的维持情况。本研究的目的是分析在至少5年的随访后，结节重新植入对患者生活质量及手术肢体功能结局的影响。
纳入62例患者。末次随访时他们的平均年龄为79±10岁。收集Katz和Lawton量表、Constant评分、DASH和SSV。在最终评估时拍摄X线片，以分析结节的位置并寻找植入物松动的影像学征象。
平均随访时间为6.7±1.5年。35例患者（56%）进行了结节重新植入。在末次随访时，两组在Katz量表（p=0.60）、Lawton量表（p=0.49）、DASH（p=0.45）或SSV（p=0.49）方面均无统计学显著差异。结节重新植入的患者Constant评分显著更好（p=0.01）；主动前屈（p=0.02）、内旋（p=0.01）和外旋手臂外展（p=0.02）也更好，但患侧肘关节外旋无显著差异（p=0.14）。没有患者因植入物松动而接受翻修手术。
结节重新植入在术后5年以上具有功能益处，尽管它似乎对老年结局或主观临床评分没有显著影响。这些患者在老年骨科人群中恢复了令人满意的独立性。
IV级——回顾性研究。
