Abstract：
BACKGROUND: Reverse shoulder arthroplasty (RSA) offers promising functional outcomes for young patients, yet challenges persist in restoring internal rotation (IR). This study aimed to assess the restoration of IR after RSA in patients younger than 60 years of age and analyze the factors affecting IR recovery.
METHODS: A retrospective multicenter study was conducted, examining the functional outcome of patients who underwent RSA, with a minimum follow-up period of 2 years. Two subgroups of patients who underwent primary RSA were analyzed separately with respect to active internal rotation with the elbow at the side (AIR1): \"difficult AIR1\" and \"easy AIR1.\"
RESULTS: The study included 136 patients (overall series) with a mean age of 51.6 years. The overall series showed statistically significant improvement in active range of motion (RoM), pain, and Constant scores, especially with active IR (p < 0.01). According to etiology, statistically significant improvement (p < 0.05) in active IR was observed for fracture sequelae, primary osteoarthritis, and rheumatoid arthritis, whereas no statistically significant improvement in IR was observed for tumor, revision, and cuff-tear arthropathy (p > 0.05). In subgroup analysis, patients with easy AIR1 displayed a statistically significant lower body mass index and better Constant score mobility, as well as improved motion in forward elevation and active IR (p < 0.05). No statistically significant associations were found between improved IR and prosthetic design or subscapularis repair. Scapular notch, lysis of the graft, and teres minor atrophy were significantly associated with better active IR (p < 0.05).
CONCLUSIONS: RSA improves active RoM, pain, and functional outcomes in patients aged under 60. However, the degree of improvement in IR may vary depending on several factors and the underlying etiologies. These insights are crucial for patient selection and counseling, guiding RSA optimization efforts.
METHODS: IV.
METHODS: A retrospective multicenter study was conducted, examining the functional outcome of patients who underwent RSA, with a minimum follow-up period of 2 years. Two subgroups of patients who underwent primary RSA were analyzed separately with respect to active internal rotation with the elbow at the side (AIR1): \"difficult AIR1\" and \"easy AIR1.\"
RESULTS: The study included 136 patients (overall series) with a mean age of 51.6 years. The overall series showed statistically significant improvement in active range of motion (RoM), pain, and Constant scores, especially with active IR (p < 0.01). According to etiology, statistically significant improvement (p < 0.05) in active IR was observed for fracture sequelae, primary osteoarthritis, and rheumatoid arthritis, whereas no statistically significant improvement in IR was observed for tumor, revision, and cuff-tear arthropathy (p > 0.05). In subgroup analysis, patients with easy AIR1 displayed a statistically significant lower body mass index and better Constant score mobility, as well as improved motion in forward elevation and active IR (p < 0.05). No statistically significant associations were found between improved IR and prosthetic design or subscapularis repair. Scapular notch, lysis of the graft, and teres minor atrophy were significantly associated with better active IR (p < 0.05).
CONCLUSIONS: RSA improves active RoM, pain, and functional outcomes in patients aged under 60. However, the degree of improvement in IR may vary depending on several factors and the underlying etiologies. These insights are crucial for patient selection and counseling, guiding RSA optimization efforts.
METHODS: IV.
摘要：
背景：反向肩关节成形术（RSA）为年轻患者提供了有希望的功能结果，然而，在恢复内部旋转（IR）方面仍然存在挑战。本研究旨在评估60岁以下患者RSA后IR的恢复情况，并分析影响IR恢复的因素。
方法：进行了回顾性多中心研究，检查接受RSA的患者的功能结局，至少随访2年。分别分析了两个接受原发性RSA的患者亚组的活动性（AIR1）：“困难AIR1”和“容易AIR1”。
结果：该研究包括136名患者（整体系列），平均年龄为51.6岁。总体系列显示活动范围（RoM）有统计学上的显着改善，疼痛,和恒定的分数，特别是具有活性IR(p<0.01)。根据病因,对于骨折后遗症，观察到活性IR的统计学显着改善（p<0.05），原发性骨关节炎，和类风湿性关节炎，虽然肿瘤内旋没有观察到统计学上的显着改善，修订版,袖口撕裂性关节病(p>0.05)。在亚组分析中，容易AIR1的患者表现出统计学上显着的较低体重指数和较好的Constant评分移动性，以及改善的运动在前高度和主动IR（p<0.05）。在改善的IR与假体设计或肩cap下修复之间没有发现统计学上的显着关联。肩胛骨缺口,移植物的裂解，和小圆区萎缩与较好的活动性IR显著相关(p<0.05)。
结论：RSA提高了活性RoM，疼痛,60岁以下患者的功能结局。然而,IR的改善程度可能因几个因素和潜在病因而异.这些见解对于患者选择和咨询至关重要，指导RSA优化工作。
方法：IV.
方法：进行了回顾性多中心研究，检查接受RSA的患者的功能结局，至少随访2年。分别分析了两个接受原发性RSA的患者亚组的活动性（AIR1）：“困难AIR1”和“容易AIR1”。
结果：该研究包括136名患者（整体系列），平均年龄为51.6岁。总体系列显示活动范围（RoM）有统计学上的显着改善，疼痛,和恒定的分数，特别是具有活性IR(p<0.01)。根据病因,对于骨折后遗症，观察到活性IR的统计学显着改善（p<0.05），原发性骨关节炎，和类风湿性关节炎，虽然肿瘤内旋没有观察到统计学上的显着改善，修订版,袖口撕裂性关节病(p>0.05)。在亚组分析中，容易AIR1的患者表现出统计学上显着的较低体重指数和较好的Constant评分移动性，以及改善的运动在前高度和主动IR（p<0.05）。在改善的IR与假体设计或肩cap下修复之间没有发现统计学上的显着关联。肩胛骨缺口,移植物的裂解，和小圆区萎缩与较好的活动性IR显著相关(p<0.05)。
结论：RSA提高了活性RoM，疼痛,60岁以下患者的功能结局。然而,IR的改善程度可能因几个因素和潜在病因而异.这些见解对于患者选择和咨询至关重要，指导RSA优化工作。
方法：IV.
