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手臂优势是否与肩膀关节置换术后临床上有意义的结果差异有关?
Asimina Lazaridou1,2, Periklis Giannakis3,4, Tim Schneller1
1Department for Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland.
Clinical orthopaedics and related research
|February 27, 2026
概括
手臂的主导地位不会影响肩膀关节整形手术的总体结果. 许多患者在TSA后没有达到临床重要差异 (MCID) 或患者可接受的症状状态 (PASS),无论手术的肢体如何.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 康复医学 康复医学 康复医学
背景情况:
- 有证据表明,主导肢体使用可能会改善肩膀全关节整形术 (TSA) 后的运动范围 (ROM).
- 目前尚不清楚实现物理治疗里程碑是否与临床上有意义的患者报告结果测量 (PROM) 差异相关.
研究的目的:
- 确定SPADI,QuickDASH,疼痛NRS和Constant-Murley分数的12个月最低临床重要差异 (MCID) 和患者可接受的症状状态 (PASS) 值.
- 调查在12个月后主导和非主导侧TSA之间实现MCID或PASS的差异.
主要方法:
- 从一个专业的骨科注册表 (2006-2024) 追溯分析了2152例初级解剖或逆转TSA病例.
- 在基线和术后12个月评估的PROMs (SPADI,QuickDASH,NRS,Constant-Murley).
- 使用基于的MCID进行基于分布和灵敏度的分析;调整后勤回归比较主导与非主导组.
主要成果:
- 在12个月内,主导和非主导肩膀之间在MCID或PASS成就方面没有临床重要差异.
- 大约25%的患者没有达到QuickDASH MCID,超过10%的患者没有达到疼痛MCID.
- 调整后的模型显示,手臂优势与在PROM中实现MCID或PASS之间没有关联.
结论:
- 手臂优势不是影响TSA后MCID或PASS成就的重要因素.
- 很大一部分患者在TSA后没有达到MCID或PASS值,无论手术的肢体如何.
- 在TSA后的术后恢复期望不应该严重依赖于手臂优势作为决定因素.
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