PDF(Pubmed)
Abstract：
The present meta-analysis was conducted to compare the safety and effectiveness of reverse shoulder arthroplasty (RSA) and hemiarthroplasty (HA) in the treatment of osteoporotic proximal humeral fractures in elderly patients. The Embase, Pubmed Central, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations and Theses, Cochrane Library and Chinese Biomedical databases were searched between January 2009 and January 2022 to identify relevant studies. According to the search strategy, a total of 210 associated studies were retrieved and 16 were finally included. Review Manager 5.4 software was used for the data analysis. This study indicated that patients in the RSA group had significantly improved treatment outcomes compared with patients in the HA group, as assessed by Constant-Murley Shoulder Outcome Score (95% CI, 1.69-3.76; P<0.001), American Shoulder and Elbow Surgeons score (95% CI, 11.81-24.88; P<0.001) and shoulder range of motion (ROM; 95% CI, 3.41-9.07; P<0.001). However, the HA group was superior to the RSA group in terms of the Oxford Shoulder score (95% CI, 2.89-11.11; P<0.001). There was no significant statistical difference between the two groups in terms of the Disabilities of the Arm, Shoulder and Hand score and complications. Overall, for the treatment of osteoporotic proximal humeral fractures in the elderly, the RSA group had improved postoperative ROM and functional scores compared with the HA group, without significant difference in the incidence of complications. However, HA remains a safe and reliable treatment option.
摘要：
本Meta分析比较反向肩关节置换术(RSA)和半肩关节置换术(HA)治疗老年骨质疏松性肱骨近端骨折的安全性和有效性。Embase,PubmedCentral,护理和相关健康文献的累积指数，ProQuest论文和论文，在2009年1月至2022年1月之间搜索了Cochrane图书馆和中国生物医学数据库，以确定相关研究。根据搜索策略,共检索到210项相关研究,最终纳入16项.使用ReviewManager5.4软件进行数据分析。这项研究表明，与HA组患者相比，RSA组患者的治疗结果显着改善。根据Constant-Murley肩关节预后评分（95%CI，1.69-3.76；P<0.001），美国肩肘外科医师评分(95%CI,11.81-24.88;P<0.001)和肩关节活动度(ROM;95%CI,3.41-9.07;P<0.001)。然而,在牛津肩评分方面,HA组优于RSA组(95%CI,2.89-11.11;P<0.001).两组在手臂残疾方面无显著统计学差异,肩手评分和并发症。总的来说,用于治疗老年骨质疏松性肱骨近端骨折，与HA组相比，RSA组术后ROM和功能评分均有改善，并发症发生率无显著差异。然而,HA仍然是一种安全可靠的治疗选择。
