Clinical and functional evaluation of patients submitted to reverse arthroplasty with minimum one year of follow-up

Flávio de Oliveira França , José Marcio Alves Freitas , Pedro Couto Godinho , Dermerson Martins Gonçalves , Tertuliano Vieira , Ulisses Silva Pereira
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引用次数: 3

Abstract

Objective

To assess the clinical and functional results of patients submitted to reverse arthroplasty with a minimum follow-up of one year.

Methods

Twenty-two patients submitted to shoulder reverse arthroplasty by the Surgery and Shoulder Rehabilitation Group were retrospectively evaluated with pre and postoperative imaging analysis, analog pain scale, range of motion, and ASES functional score.

Results

Out of 19 (86.3%) patients with preoperative ASES classified as poor/bad, 11 (57.9%) progress to good/excellent after intervention, showing improvement of function, ranging from a mean preoperative ASES score of 22 (± 18.8) to a postoperative mean of 64.8 (± 27.7) (p = 0.031). Regarding the pain, there was an improvement in analog pain scale, presenting a preoperative mean of 7.64 (1–10) and a postoperative mean of 2.09 (0–7; p < 0.001). Regarding mobility, of 22 patients, 15 (68.2%) had preoperative pseudoparalysis and, of these, ten (66.7%) had an active anterior elevation greater than 90° after reverse arthroplasty. In turn, patients without pseudoparalysis had no significant gain in range of motion (p = 0.002). The authors observed active anterior elevation gain, with a preoperative mean of 76° (0–160°) and a postoperative mean of 111° (0–160°; p = 0.002).

Conclusion

Despite being a relatively new procedure in Brazil, reverse shoulder arthroplasty can be used effectively and safely in patients who were previously without treatment options such as rotator cuff arthropathy and revisions providing pain relief, improvement of function, and mobility of the upper limb.

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经至少一年随访的患者接受反向关节置换术的临床和功能评估
目的评价逆行关节置换术患者至少随访1年的临床和功能结果。方法回顾性分析外科及肩关节康复组22例肩关节置换术患者术前、术后影像学分析、模拟疼痛量表、关节活动度及as功能评分。结果19例(86.3%)术前as分为差/坏,干预后11例(57.9%)进展为良/优,功能得到改善,术前平均评分为22(±18.8)分,术后平均评分为64.8(±27.7)分(p = 0.031)。关于疼痛,模拟疼痛评分有改善,术前平均为7.64(1-10),术后平均为2.09 (0-7;p & lt;0.001)。关于活动能力,22例患者中,15例(68.2%)术前假性瘫痪,其中10例(66.7%)在反向关节置换术后活动前抬高大于90°。反过来,没有假性瘫痪的患者在活动范围方面没有明显的增加(p = 0.002)。作者观察到主动前路抬高,术前平均为76°(0-160°),术后平均为111°(0-160°;p = 0.002)。结论:尽管在巴西,反向肩关节置换术是一种相对较新的手术,但对于以前没有治疗选择的患者,如肩袖关节病和修复术,可以有效和安全地使用,从而缓解疼痛,改善功能和上肢的活动能力。
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