背景:反向全肩关节成形术(RTSA)的使用比其他肩关节手术的增加速度更大。总的来说,无论适应症如何,RTSA治疗后的临床和功能结局均良好.然而,关于患者特异性因素与RTSA后临床改善相关的证据很少.预测RTSA后的术后结果可以支持患者和医生建立更准确的患者期望并有助于治疗决策。这项研究的目的是确定退行性肩关节疾病患者RTSA术后预后的预测因素。
方法:EMBASE,PubMed,搜索CochraneLibrary和PEDro,以确定报告RTSA术后预后预测因素的队列研究。作者根据资格独立筛选出版物。使用QUIPS工具评估每个出版物的偏倚风险。给出了结果的定性描述。等级框架用于建立证据质量。
结果:共发现1986篇参考文献,其中11篇相关文章被纳入分析。偏倚风险评估为低(N=7,63.6%)或中等(N=4,36.4%)。根据证据综合,有中等质量的证据表明,身高越高,术后肩关节功能越好,和更大的术前活动范围(ROM)预测术后ROM增加。
结论:可以预测术后结果的术前预测因素是:患者身高和术前活动范围。在RTSA的术前决策中应该考虑这些因素,并有可能用于辅助术前决策。
方法:一级;系统评价。
BACKGROUND: The use of reverse total shoulder arthroplasty (RTSA) has increased at a greater rate than other shoulder procedures. In general, clinical and functional outcomes after RTSA have been favorable regardless of indication. However, little evidence exists regarding patient specific factors associated with clinical improvement after RTSA. Predicting postoperative outcomes after RTSA may support patients and physicians to establish more accurate patient expectations and contribute in treatment decisions. The aim of this study was to determine predictive factors for postoperative outcomes after RTSA for patients with degenerative shoulder disorders.
METHODS: EMBASE, PubMed, Cochrane Library and PEDro were searched to identify cohort studies reporting on predictive factors for postoperative outcomes after RTSA. Authors independently screened publications on eligibility. Risk of bias for each publication was assessed using the QUIPS tool. A qualitative description of the results was given. The GRADE framework was used to establish the quality of evidence.
RESULTS: A total of 1986 references were found of which 11 relevant articles were included in the analysis. Risk of bias was assessed as low (N = 7, 63.6%) or moderate (N = 4, 36.4%). According to the evidence synthesis there was moderate-quality evidence indicating that greater height predicts better postoperative shoulder function, and greater preoperative range of motion (ROM) predicts increased postoperative ROM following.
CONCLUSIONS: Preoperative predictive factors that may predict postoperative outcomes are: patient height and preoperative range of motion. These factors should be considered in the preoperative decision making for a RTSA, and can potentially be used to aid in preoperative decision making.
METHODS: Level I; Systematic review.