用患者报告的结果测量信息系统评估解剖全肩关节置换术和反向全肩关节置换术的结果

Q4 Medicine

Seminars in Arthroplasty Pub Date : 2025-03-06 DOI:10.1053/j.sart.2025.02.001

Seung-Ho Ben Bae BS , Michael Doran MD , Carol A. Janney PhD , James E. Carpenter MD , Asheesh Bedi MD , Bruce S. Miller MD, MS

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引用次数: 0

摘要

在解剖和反向全肩关节置换术（rTSA）中，很少有患者报告的结果比较。此外，这两种方法的预期恢复时间尚未明确。本研究使用美国国立卫生研究院开发的患者报告结果测量信息系统（PROMIS）来比较解剖性全肩关节置换术（aTSA）和rTSA患者的术后生理功能（PF）和疼痛干扰（PI）。方法前瞻性收集2019年至2023年间接受肩关节置换术的患者的PROMIS PI和PROMIS PF评分。PI （n = 91）和PF （n = 69）的PROMIS结构域分析仅限于具有基线评分并在手术一年内至少进行一次术后评估的患者。结果与rTSA患者相比，aTSA患者在手术前（P = .07）和术后（P = .02）表现出更高的PF评分。总的来说，无论手术类型如何，PF评分从手术前到手术后均有显著改善，PF评分的绝对变化(aTSA: 5.1 + 9.0；rTSA: 3.7 + 7.3)在手术类型上无统计学差异（P = 0.47）。PF评分的显著改善主要发生在术后90天。rTSA后PI评分显著降低(−6.3 + 10.4；95%置信区间：−9.0,−3.6)和aTSA(−8.5 + 11.0；95%置信区间：−12.4,−4.5)。术前和术后的PI评分，除了术前和术后PI评分的绝对变化外，两种手术之间无统计学差异(P >；.35点)。在aTSA和rTSA后，患者在PROMIS PF和PI评分方面均有统计学意义和统计学等效的改善。结果表明，患者在手术后90天内经历了PF的快速改善，并在手术后至少维持了1年。这两种手术都能在90天内迅速缓解疼痛，90天后会出现平稳期。总的来说，这项研究的结果提供了有用的信息，关于aTSA和rTSA术后与身体功能和疼痛相关的术后恢复的时间和性质，当用PROMIS评分测量时。

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Outcomes of anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty assessed with the patient-reported outcomes measurement information system

Background

There has been little comparison of patient-reported outcomes in the setting of anatomic and reverse total shoulder arthroplasty (rTSA). Furthermore, the expected recovery timeline following the two procedures has not been well defined. This study examines the use of the National Institutes of Health-developed Patient-Reported Outcomes Measurement Information System (PROMIS) to compare the postsurgical physical function (PF) and pain interference (PI) of patients undergoing anatomic total shoulder arthroplasty (aTSA) and rTSA.

Methods

PROMIS PI and PROMIS PF scores were prospectively collected on patients undergoing shoulder arthroplasty in our practice between 2019 and 2023. Analysis for the PROMIS domains of PI (n = 91) and PF (n = 69) were restricted to patients who had baseline scores and at least 1 postsurgical assessment within a year of surgery.

Results

Patients undergoing aTSA exhibited greater PF scores at presurgery (P = .07) and postsurgery (P = .02) compared to patients undergoing rTSA. Overall, PF scores significantly improved from presurgery to postsurgery regardless of type of surgery, and the absolute change in PF scores (aTSA: 5.1 + 9.0; rTSA: 3.7 + 7.3) did not statistically differ by type of surgery (P = .47). Significant improvements in PF scores primarily occurred in the first 90 days after surgery. PI scores significantly decreased after both rTSA (−6.3 + 10.4; 95% confidence interval: −9.0, −3.6) and aTSA (−8.5 + 11.0; 95% confidence interval: −12.4, −4.5). PI scores at presurgery and postsurgery, in addition to the absolute change in PI scores from presurgery to postsurgery, did not differ statistically between the two procedures (P > .35).

Discussion

Patients experienced statistically significant and statistically equivalent improvements in PROMIS PF and PI scores after both aTSA and rTSA. The results suggest that patients experience a rapid improvement in PF within 90 days of surgery, which is maintained for at least up to 1 year after surgery. Both surgeries also result in rapid improvements in pain within 90 days, with a plateau effect after the 90-day mark. Overall, the results of this study yield useful information regarding the timeline and nature of postsurgical recovery related to physical functional and pain after aTSA and rTSA when measured with PROMIS scores.

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来源期刊

Seminars in Arthroplasty Medicine-Surgery

CiteScore

1.00

自引率

0.00%

发文量

104

期刊介绍： Each issue of Seminars in Arthroplasty provides a comprehensive, current overview of a single topic in arthroplasty. The journal addresses orthopedic surgeons, providing authoritative reviews with emphasis on new developments relevant to their practice.