Abstract：
BACKGROUND: The purpose of this multi-centre study was to assess external rotation in a large cohort following reverse shoulder arthroplasty (RSA) at a minimum follow-up of 2 years, and identify factors that influence postoperative and/or net-improvement of external rotation.
METHODS: The authors retrospectively reviewed records of 743 RSAs performed between January 2015 and August 2017 by 16 surgeons that participated in a large national society symposium; 193 (25.7%) were lost to follow-up, 16 (2.1%) died, and 33 (4.4%) were revised with implant exchange, which left 501 available for assessment at 2.0-5.5 years. Pre- and post-operative active forward elevation, active external rotation (ER1), active internal rotation (IR1) and constant score (CS) were collected. Regression analyses were performed to determine associations of patient demographics, surgical and implant parameters, rotator cuff muscles status and radiographic angles with ER1.
RESULTS: Multivariable analyses revealed postoperative ER1 decreased with age (β, - 0.35), increased with lateralisation shoulder angle (LSA) (β, 0.26), and was better in shoulders operated by the antero-superior (AS) approach (β, 11.41), but worse in shoulders with absent/atrophic teres minor muscles (β, - 10.06). Net-improvement of ER1 increased with LSA (β, 0.39), was better with inlay stems (β, 8.33) and BIO RSA (β, 6.22), but worse in shoulders operated for primary OA with rotator cuff (RC) tears (β, - 16.26), for secondary OA due to RC tears (β, - 16.06), or for mRCT (β, - 18.96).
CONCLUSIONS: This large multi-centre study revealed that, at a minimum of 2 years following RSA, ER1 improved by 16.1°. Postoperative ER1 was better in shoulders which had normal or hypertrophic teres minor muscles, were operated by the AS approach, or with greater LSA. Net-improvement of ER1 was better in shoulders with inlay stems, with BIO RSA, or with greater LSA, but worse in shoulders with rotator cuff deficiency.
METHODS: IV.
METHODS: The authors retrospectively reviewed records of 743 RSAs performed between January 2015 and August 2017 by 16 surgeons that participated in a large national society symposium; 193 (25.7%) were lost to follow-up, 16 (2.1%) died, and 33 (4.4%) were revised with implant exchange, which left 501 available for assessment at 2.0-5.5 years. Pre- and post-operative active forward elevation, active external rotation (ER1), active internal rotation (IR1) and constant score (CS) were collected. Regression analyses were performed to determine associations of patient demographics, surgical and implant parameters, rotator cuff muscles status and radiographic angles with ER1.
RESULTS: Multivariable analyses revealed postoperative ER1 decreased with age (β, - 0.35), increased with lateralisation shoulder angle (LSA) (β, 0.26), and was better in shoulders operated by the antero-superior (AS) approach (β, 11.41), but worse in shoulders with absent/atrophic teres minor muscles (β, - 10.06). Net-improvement of ER1 increased with LSA (β, 0.39), was better with inlay stems (β, 8.33) and BIO RSA (β, 6.22), but worse in shoulders operated for primary OA with rotator cuff (RC) tears (β, - 16.26), for secondary OA due to RC tears (β, - 16.06), or for mRCT (β, - 18.96).
CONCLUSIONS: This large multi-centre study revealed that, at a minimum of 2 years following RSA, ER1 improved by 16.1°. Postoperative ER1 was better in shoulders which had normal or hypertrophic teres minor muscles, were operated by the AS approach, or with greater LSA. Net-improvement of ER1 was better in shoulders with inlay stems, with BIO RSA, or with greater LSA, but worse in shoulders with rotator cuff deficiency.
METHODS: IV.
摘要：
背景：这项多中心研究的目的是评估反向肩关节置换术（RSA）后的大型队列中的外部旋转，至少随访2年，并确定影响术后和/或外旋转净改善的因素。
方法：作者回顾性回顾了2015年1月至2017年8月期间由16名外科医生进行的743份记录，这些记录参加了一个大型的全国性社会研讨会；193份（25.7%）的随访失败，16人(2.1%)死亡，33(4.4%)进行了植入物更换修订，这使得501在2.0-5.5年可供评估。术前、术后主动前高程,主动外部旋转(ER1)，收集主动内旋（IR1）和恒定评分（CS）。进行回归分析以确定患者人口统计学的关联，手术和植入参数，肩袖肌肉状态和放射角度与ER1。
结果：多变量分析显示术后ER1随着年龄的增加而降低（β，-0.35),随着侧方肩角（LSA）（β，0.26),并且通过前上(AS)方法(β，11.41),但在肩部有缺失/萎缩的小肌肉(β，-10.06)。ER1的净改善随LSA增加(β，0.39),镶嵌茎更好(β，8.33)和生物RSA(β，6.22),但患有肩袖（RC）撕裂的原发性OA手术的肩部情况更糟（β，-16.26),对于由于RC撕裂引起的继发性OA(β，-16.06),或mRCT(β，-18.96)。
结论：这项大型多中心研究表明，在RSA之后至少2年，ER1提高了16.1°。术后ER1在有正常或肥大的小肌肉的肩部更好，是通过AS方法操作的，或更大的LSA。ER1的净改善在具有镶嵌茎的肩部更好，BIORSA,或者更大的LSA，但肩袖缺乏的肩膀更严重。
方法：IV.
方法：作者回顾性回顾了2015年1月至2017年8月期间由16名外科医生进行的743份记录，这些记录参加了一个大型的全国性社会研讨会；193份（25.7%）的随访失败，16人(2.1%)死亡，33(4.4%)进行了植入物更换修订，这使得501在2.0-5.5年可供评估。术前、术后主动前高程,主动外部旋转(ER1)，收集主动内旋（IR1）和恒定评分（CS）。进行回归分析以确定患者人口统计学的关联，手术和植入参数，肩袖肌肉状态和放射角度与ER1。
结果：多变量分析显示术后ER1随着年龄的增加而降低（β，-0.35),随着侧方肩角（LSA）（β，0.26),并且通过前上(AS)方法(β，11.41),但在肩部有缺失/萎缩的小肌肉(β，-10.06)。ER1的净改善随LSA增加(β，0.39),镶嵌茎更好(β，8.33)和生物RSA(β，6.22),但患有肩袖（RC）撕裂的原发性OA手术的肩部情况更糟（β，-16.26),对于由于RC撕裂引起的继发性OA(β，-16.06),或mRCT(β，-18.96)。
结论：这项大型多中心研究表明，在RSA之后至少2年，ER1提高了16.1°。术后ER1在有正常或肥大的小肌肉的肩部更好，是通过AS方法操作的，或更大的LSA。ER1的净改善在具有镶嵌茎的肩部更好，BIORSA,或者更大的LSA，但肩袖缺乏的肩膀更严重。
方法：IV.
