Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty?

被引:54
作者
Austin, Luke [1 ]
Zmistowski, Benjamin [1 ]
Chang, Edward S. [1 ]
Williams, Gerald R., Jr. [1 ]
机构
[1] Thomas Jefferson Univ Hosp, Rothman Inst Orthopaed, Philadelphia, PA 19107 USA
关键词
CUFF; PROSTHESIS; RUPTURE;
D O I
10.1007/s11999-010-1685-x
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
Reverse shoulder arthroplasty (RSA) improves function in selected patients with complex shoulder problems. However, we presume patient function would vary if performed primarily or for revision and would vary with other patient-specific factors. We compared (1) the shoulder scores and (2) complications in patients with RSA for revision arthroplasty with patients who had RSA as a primary procedure; and (3) identified patient-specific factors that affect (1) and (2). We retrospectively compared 28 RSAs for failed arthroplasty with a control group consisting of 28 primary RSAs. We determined the Penn Shoulder (PENN), American Shoulder and Elbow Surgeons (ASES), and Single Assessment Numeric Evaluation (SANE) scores. Followup for shoulder outcome measures averaged 17.4 (range, 4.1-34) and 20.8 months (range, 7.3-34.9) for the study and control groups, respectively. All scores were higher in primary RSA than in revision RSA (PENN score, 79.5 versus 57.1; ASES score, 81.4 versus 56.3; SANE score, 73.8% versus 48.8%), and ROM was better (122.7A degrees versus 83.75A degrees). Both groups experienced increases in active forward flexion. Ten of the 28 study RSAs (35.7%) versus five of the 28 control RSAs (17.8%) had complications. No patient-specific factors other than reason for surgery correlated with scores. Revision RSA is associated with lower function compared with primary RSA. However, we believe it a reasonable alternative and patients undergoing RSA for revision arthroplasty can expect improvements in function and shoulder scores to a mean of 50% of normal shoulders but must also accept a high complication rate. Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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收藏
页码:2531 / 2537
页数:7
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