Abstract：
BACKGROUND: The aim of this study was to compare outcomes and complications in patients with and without a history of prior rotator cuff surgery who underwent reverse total shoulder arthroplasty (RTSA).
METHODS: Two-hundred and nine consecutive patients who had undergone RTSA for rotator cuff insufficiency with a minimum 12-months follow-up period were reviewed. A total of 35 patients with a history of prior rotator cuff surgery were made the study group (PS group). Using propensity score matching for age and sex, these patients were matched 1:3 with a control group of 105 patients with no history of prior surgery (NPS group). The mean follow-up period was 41.4 months.
RESULTS: Both groups showed a significant improvement of clinical scores and range of motion after RTSA. The PS group showed a significantly higher final visual analog scale (VAS) pain score compared with the NPS group (P = 0.020). The PS group showed a significantly higher incidence of acromial stress fracture compared with the NPS group (17.1% vs 4.8%, P = 0.018), but no significant difference in the overall complication rate was observed (25.7% vs 13.3%, P > 0.05). The PS group showed a significantly higher reoperation rate compared with the NPS group (14.3% vs 1.9%, P = 0.004).
CONCLUSIONS: Our study demonstrated that a history of prior rotator cuff surgery was associated with a high incidence of acromial stress fracture and reoperation after RTSA as well as a high final VAS pain score, although satisfactory clinical outcomes after RTSA were achieved in both groups.
METHODS: Two-hundred and nine consecutive patients who had undergone RTSA for rotator cuff insufficiency with a minimum 12-months follow-up period were reviewed. A total of 35 patients with a history of prior rotator cuff surgery were made the study group (PS group). Using propensity score matching for age and sex, these patients were matched 1:3 with a control group of 105 patients with no history of prior surgery (NPS group). The mean follow-up period was 41.4 months.
RESULTS: Both groups showed a significant improvement of clinical scores and range of motion after RTSA. The PS group showed a significantly higher final visual analog scale (VAS) pain score compared with the NPS group (P = 0.020). The PS group showed a significantly higher incidence of acromial stress fracture compared with the NPS group (17.1% vs 4.8%, P = 0.018), but no significant difference in the overall complication rate was observed (25.7% vs 13.3%, P > 0.05). The PS group showed a significantly higher reoperation rate compared with the NPS group (14.3% vs 1.9%, P = 0.004).
CONCLUSIONS: Our study demonstrated that a history of prior rotator cuff surgery was associated with a high incidence of acromial stress fracture and reoperation after RTSA as well as a high final VAS pain score, although satisfactory clinical outcomes after RTSA were achieved in both groups.
摘要：
背景：本研究的目的是比较有和没有肩袖手术史的患者行反向全肩关节置换术（RTSA）的结果和并发症。
方法：回顾了两百零九例连续接受RTSA治疗肩袖功能不全的患者，随访时间至少为12个月。将35例有肩袖手术史的患者作为研究组（PS组）。使用年龄和性别的倾向评分匹配，这些患者与105例没有手术史的对照组(NPS组)1:3匹配.平均随访期为41.4个月。
结果：两组均显示出RTSA后临床评分和活动范围的显着改善。与NPS组相比，PS组显示出明显更高的最终视觉模拟评分（VAS）疼痛评分（P=0.020）。PS组的肩峰应力性骨折发生率明显高于NPS组（17.1%vs4.8%，P=0.018),但总体并发症发生率无显著差异(25.7%vs13.3%,P>0.05)。PS组的再手术率明显高于NPS组（14.3%vs1.9%，P=0.004)。
结论：我们的研究表明，既往肩袖手术史与肩峰应力性骨折和RTSA术后再手术的高发生率以及高最终VAS疼痛评分相关。虽然两组在RTSA治疗后均取得了满意的临床结局.
方法：回顾了两百零九例连续接受RTSA治疗肩袖功能不全的患者，随访时间至少为12个月。将35例有肩袖手术史的患者作为研究组（PS组）。使用年龄和性别的倾向评分匹配，这些患者与105例没有手术史的对照组(NPS组)1:3匹配.平均随访期为41.4个月。
结果：两组均显示出RTSA后临床评分和活动范围的显着改善。与NPS组相比，PS组显示出明显更高的最终视觉模拟评分（VAS）疼痛评分（P=0.020）。PS组的肩峰应力性骨折发生率明显高于NPS组（17.1%vs4.8%，P=0.018),但总体并发症发生率无显著差异(25.7%vs13.3%,P>0.05)。PS组的再手术率明显高于NPS组（14.3%vs1.9%，P=0.004)。
结论：我们的研究表明，既往肩袖手术史与肩峰应力性骨折和RTSA术后再手术的高发生率以及高最终VAS疼痛评分相关。虽然两组在RTSA治疗后均取得了满意的临床结局.
