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骨关节炎的解剖和逆向全肩关节整形手术:80岁及以上患者的结局
Albert D Mousad1, Casey M Beleckas1, Benjamin Lack2
1Levy Shoulder to Hand Center at the Paley Orthopedic and Spine Institute, Boca Raton, FL, USA.
Journal of shoulder and elbow surgery
|January 25, 2025
概括
对于80岁以上的骨关节炎患者,解剖 (aTSA) 和逆向全肩关节整形手术 (rTSA) 显示出类似的高满意度和良好的结果. 这两种手术的并发症率都很低,这使得它们成为可行的选择.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 生物医学工程 生物医学工程
背景情况:
- 在老年患者 (≥75岁) 中,解剖 (aTSA) 和逆向全肩关节整形术 (rTSA) 的发生率增加.
- aTSA是没有旋转手腕问题的关节炎的标准,但由于旋转手腕问题,rTSA在老年人中使用量正在增加.
- 八十多岁的骨关节炎管理需要仔细考虑手术选择.
研究的目的:
- 为了评估和比较初级aTSA与rTSA的结果,在80岁及以上的患有骨关节炎和完整的旋转手套的患者中.
- 评估疼痛,功能,运动范围,患者满意度和并发症率.
主要方法:
- 对肩关节整形手术病例的回顾性审查 (2006年11月至2022年2月).
- 纳入标准:患者≥80岁,原发性关节炎,没有全厚旋转手套撕裂,至少2年随访.
- 评估患者报告的结果措施 (PROMs),运动范围,力量,满意度,并发症和修订.
主要成果:
- 130名患者 (77名aTSA,53名rTSA) 符合标准;没有显著的人口差异.
- 在随访时,aTSA和rTSA组之间的PROM没有显著差异.
- aTSA在外部 (50°与40°相比) 和内部旋转 (8与5) 中显示出更大的改善,但前方升高没有差异.
- 并发症的发生率相似 (aTSA 7.8%,rTSA 5.6%),观察到不同类型的并发症 (甲下缺陷,骨折,aTSA的感染;rTSA的骨/脊柱骨折).
结论:
- aTSA 和 rTSA 两种药物在患有骨关节炎的八岁老人中都提供了高的患者满意度和良好的功能结果.
- 这两种手术方法的并发症率很低,并且在两种手术方法之间可以比较.
- 这些发现支持在符合条件的骨关节炎老年患者中使用aTSA或rTSA.
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