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Grammont式反肩关节置换术至少10年随访的长期结果:一项生存分析。

Long-term outcomes of Grammont style reverse shoulder arthroplasty at a minimum of 10-year follow-up: A survival analysis.

作者信息

Donoghue Sophie J, Williams Mark G, Burden Eleanor G, East Jamie, Batten Timothy J, Pearce Eleanor, Evans Jonathan P, Smith Christopher D

机构信息

Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.

Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, Gloucestershire, UK.

出版信息

Shoulder Elbow. 2025 Apr 18:17585732251331474. doi: 10.1177/17585732251331474.

Abstract

BACKGROUND

Reverse shoulder arthroplasty (RSA) is an established and successful treatment for rotator cuff tear arthropathy. Despite increased popularity, there is a paucity of long-term survivorship data and patient-reported outcome measures. This study aimed to establish the survival at a minimum 10-year follow-up for a Grammont-style reverse shoulder prosthesis.

METHODS

A single centre, retrospective case series of 101 primary RSAs in 86 patients, performed between 1999 and 2012 was conducted. The primary outcome measure was all-cause revision. Implant survivorship analysis using the Kaplan-Meier method was conducted. Deaths were censored. Secondary outcomes included up-to-date Oxford Shoulder Score (OSS) in surviving patients, historic OSS scores over time and radiological outcomes.

RESULTS

Mean age was 76 years (SD ± 7.29) at time of surgery. The 10-year implant survival was 93.2% (95% confidence interval [CI] 87.8-98.6). The mean OSS was 33 (range 17-48, 95% CI 29.1-36.9) with a minimum of 10-year follow-up ( = 21). Radiographic review showed scapular notching in 79% of implants over 10 years old, but no radiolucency around humeral implants.

CONCLUSIONS

The rate of RSA survivorship is high at 93.2% at 10 years. Most patients died with their primary implant . Functional outcome scores were less predictable over time.

摘要

背景

反式肩关节置换术(RSA)是治疗肩袖撕裂性关节病的一种成熟且成功的方法。尽管其应用越来越广泛,但长期生存率数据和患者报告的结局指标却很匮乏。本研究旨在确定Grammont式反式肩关节假体至少10年随访期的生存率。

方法

对1999年至2012年间在86例患者中进行的101例初次RSA手术进行单中心回顾性病例系列研究。主要结局指标是全因翻修。采用Kaplan-Meier法进行植入物生存率分析。对死亡情况进行截尾处理。次要结局包括存活患者的最新牛津肩部评分(OSS)、随时间变化的历史OSS评分以及影像学结局。

结果

手术时的平均年龄为76岁(标准差±7.29)。10年植入物生存率为93.2%(95%置信区间[CI]87.8 - 98.6)。在至少10年的随访期内(n = 21),平均OSS为33(范围17 - 48,95%CI 29.1 - 36.9)。影像学检查显示,使用超过10年的植入物中有79%出现肩胛切迹,但肱骨植入物周围未出现透光线。

结论

RSA的10年生存率较高,为93.2%。大多数患者在初次植入物在位时死亡。随着时间推移,功能结局评分的可预测性较差。

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