Harkin William E, Levin Jay M, Williams Tyler, Khan Zeeshan A, Hornung Alexander, Nicholson Gregory P, Klifto Christopher S, Garrigues Grant E
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
Department of Orthopaedic Surgery, Duke University, Durham, NC, USA.
Shoulder Elbow. 2025 May 23:17585732251343859. doi: 10.1177/17585732251343859.
The aim of this study is to identify risk factors for prolonged operative duration in anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA) for patients with glenohumeral osteoarthritis (GHOA).
A retrospective chart review of electronic medical records was conducted to identify patients who underwent shoulder arthroplasty for GHOA by one of six surgeons across two academic institutions between 2017 and 2023. Multivariate linear regression was used to identify factors associated with operative duration.
In total, 513 patients underwent primary ATSA, and 528 underwent primary RTSA. The mean operating room (OR) time was significantly longer in patients undergoing ATSA (183.5 ± 39.5 minutes) compared to those undergoing RTSA (150.5 ± 33.4 minutes). For ATSA, older patient age, male sex, increased body mass index, lower Charlson comorbidity index (CCI), increased preoperative retroversion, increased preoperative inclination, and a glenoid Walch classification of B2 or B3 were significant predictors of OR time. For RTSA, younger patient age, lower CCI, and increased preoperative retroversion were significant predictors of OR time.
ATSA has a significantly longer mean OR time than RTSA for the treatment of isolated GHOA. Preoperative demographic and radiographic data can be used to predict operative duration.
本研究的目的是确定盂肱骨关节炎(GHOA)患者行解剖型全肩关节置换术(ATSA)和反式全肩关节置换术(RTSA)时手术时间延长的风险因素。
对电子病历进行回顾性图表审查,以确定2017年至2023年期间在两个学术机构由六位外科医生之一为GHOA患者进行肩关节置换术的患者。采用多元线性回归确定与手术时间相关的因素。
共有513例患者接受了初次ATSA,528例接受了初次RTSA。与接受RTSA的患者(150.5±33.4分钟)相比,接受ATSA的患者平均手术室(OR)时间明显更长(183.5±39.5分钟)。对于ATSA,患者年龄较大、男性、体重指数增加、Charlson合并症指数(CCI)较低、术前后倾增加、术前倾斜增加以及关节盂Walch分类为B2或B3是OR时间的显著预测因素。对于RTSA,患者年龄较小、CCI较低和术前后倾增加是OR时间的显著预测因素。
对于孤立性GHOA的治疗,ATSA的平均OR时间明显长于RTSA。术前人口统计学和影像学数据可用于预测手术时间。