The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency - A minimum two-year follow-up study of sixty patients
The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency - A minimum two-year follow-up study of sixty patients
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DOI：
10.2106/jbjs.d.02813
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发表时间：
2005-08-01
影响因子：
5.3
通讯作者：
Vasey, M
中科院分区：
文献类型：
--
作者：
Frankle, M;Siegal, S;Vasey, M
背景资料：患有与严重肩袖缺陷相关的盂肱关节炎疼痛和功能障碍的患者几乎没有治疗选择。本研究的目的是回顾性评估短期结果的关节成形术与使用的反向肩关节假体在管理这个problem.Methods：我们报告的结果为60例（60肩）肩袖缺陷和盂肱关节炎谁是最低的两年。35例患者既往未接受过肩关节手术，23例接受过开放性或关节镜下肩袖修复术，1例接受过肩峰下减压术，1例接受过肱二头肌肌腱修复术。所有患者在术前和术后均采用美国肩肘外科医生疼痛和功能评分系统进行评估，并采用视觉模拟量表进行疼痛和功能评估。他们还被要求对结果进行满意度评分。结果：患者平均年龄为71岁。平均随访时间为33个月。所有指标均显著改善（p < 0.0001）。美国肩肘外科医生系统的平均总评分从34.3提高到68.2;平均功能评分从16.1提高到29.4;平均疼痛评分从18.2提高到38.7。视觉模拟量表的功能评分从2.7改善至6.0，视觉模拟量表的疼痛评分从6.3改善至2.2。前屈从55.0度增加到105.1度，外展从41.4度增加到101.8度。60例患者中有41例将结局评定为良好或极佳; 16例满意，3例不满意。10例患者（17%）共发生13例并发症。7例患者（12%）有8个失败，需要翻修手术，另一个反向肩关节假体在5例（一个肩膀有两个修订）和修订，半关节置换术在两名患者，因为深部infection.Conclusions：本研究的数据表明，关节置换术与反向肩关节假体可能是一个可行的治疗盂肱关节炎和大规模肩袖撕裂的患者。然而，未来的研究将是必要的，以确定植入物的寿命，以及它是否会提供持续的功能改善。
Background: Patients who have pain and dysfunction from glenohumeral arthritis associated with severe rotator cuff deficiency have few treatment options. The goal of this study was to retrospectively evaluate the short-term results of arthroplasty with use of the Reverse Shoulder Prosthesis in the management of this problem.Methods: We report the results for sixty patients (sixty shoulders) with a rotator cuff deficiency and glenohumeral arthritis who were followed for a minimum of two years. Thirty-five patients had no previous shoulder surgery, whereas twenty-three had had either an open or arthroscopic rotator cuff repair, one had had a subacromial decompression, and one had had a biceps tendon repair. All patients were assessed preoperatively and postoperatively with the American Shoulder and Elbow Surgeons scoring system for pain and function and with visual analog scales for pain and function. They were also asked to rate their satisfaction with the outcome. The shoulder range of motion was measured preoperatively and postoperatively.Results: The average age of the patients was seventy-one years. The average duration of follow-up was thirty-three months. All measures improved significantly (p < 0.0001). The mean total score on the American Shoulder and Elbow Surgeons system improved from 34.3 to 68.2; the mean function score, from 16.1 to 29.4; and the mean pain score, from 18.2 to 38.7. The score for function on the visual analog scale improved from 2.7 to 6.0, and the score for pain on the visual analog scale improved from 6.3 to 2.2. Forward flexion increased from 55.0 degrees to 105.1 degrees, and abduction increased from 41.4 degrees to 101.8 degrees. Forty-one of the sixty patients rated the outcome as good or excellent; sixteen were satisfied, and three were dissatisfied. There were a total of thirteen complications in ten patients (17%). Seven patients (12%) had eight failures, requiring revision surgery to another Reverse Shoulder Prosthesis in five patients (one shoulder had two revisions) and revision to a hemiarthroplasty in two patients because of deep infection.Conclusions: The data from this study suggest that arthroplasty with the Reverse Shoulder Prosthesis may be a viable treatment for patients with glenohumeral arthritis and a massive rotator cuff tear. However, future studies will be necessary to determine the longevity of the implant and whether it will provide continued improvement in function.