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Updated: Feb 13, 2026

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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
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肩の逆関節整形術と,肩の最終段階の不安定性に対する門関節整形術の比較
Ayham Jaber1,2, Tyler J Uppstrom3, Marilee P Horan1
1Steadman Philippon Research Institute, Vail, CO, USA.
JSES international
|February 12, 2026
まとめ
末期再発性肩の不安定性では,逆肩関節整形手術 (rTSA) は,グレノウメラル関節矯正 (GHA) と比較して,よりよい機能的結果とより低い修正率を提供します. 両方の手術方法は安定性をもたらしますが,RTSAは患者の機能が優れていることを示しています.
科学分野:
- 整形外科 整形外科
- 肩の不安定管理について
- 関節整形手術の結果について
背景:
- 末期再発性肩の不安定性 (RSI) には標準的な治療法がないため,保守的な治療に反応しない患者に課題が生じています.
- 線関節矯正 (GHA) と逆肩関節整形手術 (rTSA) は外科的選択肢ですが,比較結果はよく確立されていません.
研究 の 目的:
- 末期再発性肩の不安定性 (RSI) の関節縮 (Glenohumeral arthrodesis, GHA) の後の機能的アウトカムと患者の満足度を,逆関節整形術 (rTSA, reverse total shoulder arthroplasty, rTSA) と比較する.
主な方法:
- 末期RSI患者の11人の13人の肩のコホートは,GHA (n=8) またはrTSA (n=5) を受けました.
- 患者による報告結果 (ASES,SANE,QuickDASH) と満足度の測定は,手術前および手術後の状態で評価されました.
- 失敗は改修手術として定義され,持続的な不安定性と患者の満足度は主要な報告された結果でした.
主要な成果:
- rTSAグループは,アメリカン・ショルダー・アンド・エルボウ・サージュンズ (ASES) のスコア (89.6対64.4) とシングル・アセスメント・ニュメリカル・エヴァイアレーション (SANE) のスコア (85.2対60) が著しく高かった.
- 腕,肩,手 (QuickDASH) の急速障害のスコアは,rTSAグループでは著しく低く,障害が少ないことを示しました.
- 両グループとも満足度が高いと報告したが,rTSAグループはリビジョン手術が少ない (0対2) であった.
結論:
- rTSAとGHAは,終末期RSIの有効な治療法であり,安定性を提供しています.
- 逆肩関節整形手術 (rTSA) は,門関節整形手術 (GHA) と比較して,優れた機能回復と低い修正率を示しています.
- rTSAは,この患者集団における不安定性を効果的に管理しながら,よりよい肩の動きと機能を提供することができます.
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