Experiences and outcomes in shoulder replacements in a district general hospital over 19 years.

IF 1.8 Q2 ORTHOPEDICS Clinics in Shoulder and Elbow Pub Date : 2024-09-01 Epub Date: 2024-07-11 DOI:10.5397/cise.2023.01137
Andrew Peter Dekker, Jamie Hind, Neil Ashwood
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Abstract

Background: This study aimed to evaluate the changing experiences of shoulder surgeons working in a district general hospital.

Methods: A consecutive series of 395 shoulders (225 male, 170 female) over a 19-year period (2000-2019) with a minimum follow-up of 2 years were analyzed. Outcome measures were length of stay, operating time, satisfaction visual analog score (VAS), pain VAS, Oxford Shoulder Score (OSS), Constant-Murley score, range of movement, complications, and implant survival.

Results: The incidence of a diagnosis of osteoarthritis as the surgical indication increased over time. The number of cases by surgeon per year increased from three cases in 2,000 to a peak of 33 in 2011. Up to seven implant manufacturers were used. The incidence of hemiarthroplasties decreased, and more numerous reverse polarity and anatomic arthroplasties were performed (P<0.001). More glenoid and humeral components were cemented and more short-stem implants were used in later years (P<0.001). Length of stay was a median of 1 day with a trend towards daytime surgery in recent years. Patients were satisfied (VAS 8/10) and OSS improved by 8 points on average throughout the observation period.

Conclusions: Despite frequent introductions of new implants, patient outcome, satisfaction, and complication rates remained good. There appears to be a need for large-scale, generalizable studies to understand why technological advancements leading to changes in implants do not influence clinical outcomes. Level of evidence: III.

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一家地区综合医院 19 年来在肩关节置换方面的经验和成果。
背景:本研究旨在评估在一家地区综合医院工作的肩部外科医生的经验变化:本研究旨在评估在一家地区综合医院工作的肩部外科医生的经验变化:分析了 19 年间(2000-2019 年)连续 395 例肩部手术(男性 225 例,女性 170 例),随访时间至少 2 年。结果指标包括住院时间、手术时间、满意度视觉模拟评分(VAS)、疼痛VAS、牛津肩关节评分(OSS)、康斯坦茨-默里评分、活动范围、并发症和植入物存活率:结果:骨关节炎诊断作为手术指征的发生率随着时间的推移而增加。外科医生每年的手术病例数从2000例中的3例增加到2011年的33例。使用的植入物制造商多达七家。半关节置换术的发生率有所下降,反极性和解剖关节置换术的数量有所增加(PC结论:尽管新的植入物不断推出,但手术适应症却在不断增加:尽管新的植入体频频问世,但患者的治疗效果、满意度和并发症发生率依然良好。似乎有必要进行大规模、可推广的研究,以了解为什么技术进步导致的植入物变化不会影响临床结果。证据等级:III级。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
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