Konarski Alastair, Ribenzaft Shay, Coghlan Jennifer, Bell Simon
Melbourne Shoulder and Elbow Centre, Sandringham, Melbourne, Victoria, Australia.
Dept. of Surgery, School of Clinical Science, Monash Health, Monash University, Australia.
J Orthop. 2025 May 9;65:211-215. doi: 10.1016/j.jor.2025.05.020. eCollection 2025 Jul.
Reverse Shoulder Arthroplasty (RSA) was initially designed for low demand patients with cuff tear arthropathy (CTA), but its indications have expanded. The aim was to investigate whether the indication affected the outcome.
This was a prospective study. All patients receiving a Stryker Perform Wedged Augmented Glenoid were included. Patients were classified as glenohumeral arthritis (OA), or CTA, using pre-operative imaging and intra-operative findings. Patients had assessments including range of movement (ROM), ASES, SPADI, DASH and Constant Scores, and complications.
62 patients were included, 30 with OA, and 32 with CTA. Post-operative scores were better in OA for DASH (13.8 vs 24.7, p = 0.02) and Constant (68.2 vs 58.7, p = 0.02).ROM showed improved elevation (139° vs 122°, p = 0.03) and abduction (81° vs 71°, p = 0.046) in OA, with no difference in internal or external rotation.There were significantly more complications in the CTA group (38 % vs 13 %), particularly in acromial stress fractures and reactions (ASFR) (25 % vs 0 %).
OA patients have better post-operative scores and ROM. They had fewer complications, particularly ASFR. Outcome differences may be partly explained by the complication profiles. The indication for RSA is an important consideration and should be reported in future outcome studies.
反式肩关节置换术（RSA）最初是为需求较低的肩袖撕裂性关节病（CTA）患者设计的，但现在其适应症有所扩大。本研究旨在探讨适应症是否会影响手术效果。
这是一项前瞻性研究。纳入所有接受史赛克Perform楔形增强型肩胛盂的患者。根据术前影像学检查和术中发现，将患者分为盂肱关节炎（OA）或CTA。对患者进行包括活动范围（ROM）、ASES、SPADI、DASH和Constant评分以及并发症的评估。
共纳入62例患者，其中30例为OA，32例为CTA。OA患者术后DASH评分（13.8对24.7，p = 0.02）和Constant评分（68.2对58.7，p = 0.02）更好。OA患者的ROM显示抬高（139°对122°，p = 0.03）和外展（81°对71°，p = 0.046）有所改善，内旋或外旋无差异。CTA组的并发症明显更多（38%对13%），尤其是肩峰应力骨折和反应（ASFR）（25%对0%）。
OA患者术后评分和ROM更好。他们的并发症更少，尤其是ASFR。手术效果的差异可能部分由并发症情况来解释。RSA的适应症是一个重要的考虑因素，应在未来的手术效果研究中予以报告。
