Sex-related differences in patients undergoing surgery for shoulder instability: a Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort study

被引:20
作者
Magnuson, Justin A. [1 ]
Wolf, Brian R. [2 ]
Cronin, Kevin J. [1 ]
Jacobs, Cale A. [1 ]
Ortiz, Shannon F. [2 ]
Bishop, Julie Y. [3 ]
Baumgarten, Keith M. [4 ]
Hettrich, Carolyn M. [1 ]
Bollier, Matthew J. [2 ]
Bravman, Jonathan T. [5 ]
Brophy, Robert H. [6 ]
Cox, Charles L. [7 ]
Feeley, Brian T. [8 ]
Grant, John A. [9 ]
Jones, Grant L. [3 ]
Kuhn, John E. [7 ]
Ma, C. Benjamin [8 ]
Marx, Robert G. [10 ]
McCarty, Eric C. [5 ]
Miller, Bruce S. [9 ]
Seidl, Adam J. [5 ]
Smith, Matthew V. [6 ]
Wright, Rick W. [6 ]
Zhang, Alan L. [8 ]
机构
[1] Univ Kentucky Orthopaed Surg & Sports Med, Lexington, KY USA
[2] Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA
[3] Ohio State Univ, Ctr Sports Med, Columbus, OH 43210 USA
[4] Orthoped Inst, Sioux Falls, SD USA
[5] Univ Colorado, Sch Med, Dept Orthoped, Aurora, CO USA
[6] Washington Univ, Dept Orthoped, St Louis, MO USA
[7] Vanderbilt Univ, Med Ctr, Dept Orthopaed Surg & Rehabil, Nashville, TN USA
[8] Univ Calif San Francisco, Dept Orthopaed Surg, San Francisco, CA USA
[9] Univ Michigan, Dept Orthopaed Surg, MedSport, Ann Arbor, MI 48109 USA
[10] Hosp Special Surg, Dept Sports Med, 535 E 70th St, New York, NY 10021 USA
关键词
Shoulder instability; shoulder instability surgery; sex-based analysis; patient-reported outcomes; FEDS classification; MOON shoulder; CRUCIATE LIGAMENT TEAR; ANTERIOR; WOMEN; INJURIES;
D O I
10.1016/j.jse.2019.02.020
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Hypothesis and background: Male sex has been identified as a risk factor for both primary shoulder dislocation and recurrent instability, and male patients more often undergo surgery for instability. Despite published discrepancies between sexes regarding the incidence and surgical rates of shoulder instability, there is little detail on the differences in presentation, mechanism of injury, and intraoperative findings. The purpose of this study was to explore these differences. Methods: Prospective baseline data from 1010 patients in the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort were analyzed for sex-related differences using demographic characteristics, patient-reported outcomes, radiographic findings, intraoperative findings, and surgical procedures performed. Two-tailed t tests and chi(2) tests were used to compare the continuous and categorical data, respectively. Patients were categorized using the Frequency, Etiology, Direction, Severity (FEDS) classification system. Results: Male patients comprised 81.3% of the cohort. Male patients had a significantly higher rate of traumatic instability and rate of initial instability while playing sports, as well as significantly higher activity scores. Female patients had significantly lower preoperative American Shoulder and Elbow Surgeons, Western Ontario Shoulder Instability Index, 36-Item Health Survey, and Single Assessment Numeric Evaluation scores. No difference in the number of dislocations was found between male and female patients. Intraoperatively, male patients had higher rates of labral pathology and bone loss whereas female patients had higher rates of capsular laxity. These differences resulted in more Latarjet procedures for male patients and more soft-tissue procedures for female patients. Conclusion: There are differences between male and female patients in the etiology of their instability, baseline patient-reported outcomes, and associated shoulder pathology, likely reflecting intrinsic and activity-related variation. These differences may influence clinical decision making and patient outcomes. (C) 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
引用
收藏
页码:1013 / 1021
页数:9
相关论文
共 28 条
  • [1] Excess mortality following hip fracture: a systematic epidemiological review
    Abrahamsen, B.
    van Staa, T.
    Ariely, R.
    Olson, M.
    Cooper, C.
    [J]. OSTEOPOROSIS INTERNATIONAL, 2009, 20 (10) : 1633 - 1650
  • [2] Sex Differences in Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction
    Ageberg, Eva
    Forssblad, Magnus
    Herbertsson, Par
    Roos, Ewa M.
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2010, 38 (07) : 1334 - 1342
  • [3] Correlation of anthropometric measurements, strength, anterior cruciate ligament size, and intercondylar notch characteristics to sex differences in anterior cruciate ligament tear rates
    Anderson, AF
    Dome, DC
    Gautam, S
    Awh, MH
    Rennirt, GW
    [J]. AMERICAN JOURNAL OF SPORTS MEDICINE, 2001, 29 (01) : 58 - 66
  • [4] Boyle-Walker K L, 1997, J Hand Ther, V10, P222
  • [5] Metabolic impact of sex hormones on obesity
    Brown, Lynda M.
    Gent, Lana
    Davis, Kathryn
    Clegg, Deborah J.
    [J]. BRAIN RESEARCH, 2010, 1350 : 77 - 85
  • [6] Busija L, 2011, ARTHRIT CARE RES, V63, pS383, DOI 10.1002/acr.20541
  • [7] Sex-based Differences in Common Sports Injuries
    Carter, Cordelia W.
    Ireland, Mary Lloyd
    Johnson, Anthony E.
    Levine, William N.
    Martin, Scott
    Bedi, Asheesh
    Matzkin, Elizabeth G.
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS, 2018, 26 (13) : 447 - 454
  • [8] Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support
    Harris, Paul A.
    Taylor, Robert
    Thielke, Robert
    Payne, Jonathon
    Gonzalez, Nathaniel
    Conde, Jose G.
    [J]. JOURNAL OF BIOMEDICAL INFORMATICS, 2009, 42 (02) : 377 - 381
  • [9] Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival
    Kannegaard, Pia Nimann
    van der Mark, Susanne
    Eiken, Pia
    Abrahamsen, Bo
    [J]. AGE AND AGEING, 2010, 39 (02) : 203 - 209
  • [10] Scoring systems for the functional assessment of the shoulder
    Kirkley, A
    Griffin, S
    Dainty, K
    [J]. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2003, 19 (10) : 1109 - 1120