反向全肩关节置换术后满意的复工率。

IF 4.6 1区医学 Q1 ORTHOPEDICS

Bone & Joint Journal Pub Date : 2025-09-01 DOI:10.1302/0301-620X.107B9.BJJ-2024-1587.R2

Alberto Pedrazzini, Flamur Zendeli, Bettina Hochreiter, Samy Bouaicha, Karl Wieser, Philipp Kriechling

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引用次数: 0

摘要

目的：目的是分析逆行全肩关节置换术（RTSA）植入术后恢复工作（RTW）的能力，特别关注重体力劳动者。方法：回顾性评估2005年9月至2021年10月期间接受RTSA的所有年龄小于60岁的工作患者的RTW能力。收集患者的基本人口统计信息、工作强度、工作变化情况、术前病假情况。术前和随访两年，采用Constant-Murley评分（CS）和主观肩值（SSV）、并发症和翻修手术来评估结果。采用Logistic回归分析预测RTW。结果：209例符合条件的患者中有167例在手术时就业，中位年龄55岁（IQR 50.3 ~ 57.8），女性占34.1% (n = 57)，其中轻、中、重度工作强度分别为75例（44.9%）、61例（36.5%）和31例（18.6%）。术后73.7%（123/167）患者中位时间为4个月（IQR 2 ~ 7）。在转职的患者中，9.8%（12/123）的患者不得不转行从事要求较低的工作。与轻度（59/75;78.7%）和中度（45/61;73.8%）相比，高强度工作的患者RTW率（19/31;61.3%）较低。RTW患者有更好的术前和术后预后，以及相对CS （76% vs 34%, p < 0.001）、疼痛CS （14 vs 7，最佳值15，p < 0.001）和SSV （75% vs 20%, p < 0.001）的更大改善。Logistic回归分析显示术前病假缺勤(OR 6.81 (95% CI 2.63 ~ 19.4)；p < 0.001)与较高的RTW发生率相关。结论：超过三分之二的术前工作患者在RTSA后能够进行RTW，这取决于工作强度。术前未请病假的患者RTW率较高。这些信息与外科医生对患者的建议高度相关，并可能限制期望，特别是对繁重的工人。

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Satisfactory return to work rates after reverse total shoulder arthroplasty.

Aims: The aim was to analyze the ability to return to work (RTW) after implantation of reverse total shoulder arthroplasty (RTSA) with special attention to heavy labourers.

Methods: All working patients younger than 60 years of age who underwent RTSA between September 2005 and October 2021 were retrospectively evaluated for their ability to RTW. Basic demographic information, job intensity, change of work, and preoperative sick leave were collected. Constant-Murley score (CS) and Subjective Shoulder Value (SSV) preoperatively and at two years' follow-up, complications, and revision surgeries were used to evaluate the outcome. Logistic regression analysis was used to predict RTW.

Results: A total of 167 of 209 eligible patients were employed at the time of surgery (median age 55 years (IQR 50.3 to 57.8), 34.1% (n = 57) female), of whom 75 (44.9%), 61 (36.5%), and 31 (18.6%) were classified to have light, medium, or heavy work intensity, respectively. Postoperatively, 73.7% (123/167) of them RTW at a median time of four months (IQR 2 to 7). Of those who RTW, 9.8% of patients (12/123) had to change occupation to less demanding jobs. Patients with high-intensity jobs had a lower RTW rate (19/31; 61.3%) compared with those with light (59/75; 78.7%) and medium-intensity jobs (45/61; 73.8%). Patients who RTW had better pre- and postoperative outcomes as well as greater improvement in relative CS (76% vs 34%; p < 0.001), CS for pain (14 vs 7 with 15 as best value; p < 0.001), and SSV (75% vs 20%; p < 0.001). Logistic regression analysis showed that absence of preoperative sick leave (OR 6.81 (95% CI 2.63 to 19.4); p < 0.001) was associated with higher RTW rates.

Conclusion: More than two-thirds of preoperatively working patients were able to RTW after RTSA, depending on work intensity. Higher RTW rates were seen in patients who were not on sick leave preoperatively. This information is highly relevant for the surgeon to counsel patients accordingly and possibly limit expectations, especially in heavy workers.

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来源期刊

Bone & Joint Journal ORTHOPEDICS-SURGERY

CiteScore

9.40

自引率

10.90%

发文量

318

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