Impact of age on functional outcome after reverse shoulder arthroplasty performed for proximal humerus fractures or their sequelae

سال انتشار: 1402
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 136

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شناسه ملی سند علمی:

JR_TABO-11-1_004

تاریخ نمایه سازی: 18 دی 1401

چکیده مقاله:

Background: The use of reverse shoulder arthroplasty (RSA) to treat displaced, unstable ۳- and ۴-part proximal humerus fractures (PHFs) has traditionally been reserved for patients over ۷۰ years old. However, recent data suggest that nearly one third of all patients treated with RSA for PHF are between ۵۵-۶۹ years old. The purpose of this study was to compare outcomes for patients younger than ۷۰ versus patients older than ۷۰ years of age treated with RSA for a PHF or fracture sequelae. Methods: All patients who underwent primary RSA for acute PHF or fracture sequelae (nonunion, malunion) between ۲۰۰۴ and ۲۰۱۶ were identified. A retrospective cohort study was performed comparing outcomes for patients younger than ۷۰ versus patients older than ۷۰. Bivariate and survival analyses were performed to evaluate for differences in complications, functional outcomes, and implant survival.Results: A total of ۱۱۵ patients were identified, including ۳۹ patients in the young group and ۷۶ patients in the older group. ۴۰ patients (۴۳.۵%) returned functional outcomes surveys at an average of ۵.۵۱ years (range ۳.۰۴-۱۱.۰). There were no significant differences in complications, reoperation, implant survival, range of motion, DASH (۲۷.۹ vs ۲۳.۸, p=۰.۴۶), PROMIS (۴۳.۳ vs ۴۳.۶, p=۰.۹۳), or EQ۵D (۰.۷۵ vs ۰.۸۰, p=۰.۳۶) scores between the two age cohorts.Conclusion: At a minimum of ۳ years after RSA for a complex PHF or fracture sequelae, we found no significant difference in complications, reoperation rates, or functional outcomes between younger patients with an average age of ۶۴ years and older patients with an average age of ۷۸ years. To our knowledge, this is the first study to specifically examine the impact of age on outcome after RSA for the treatment of a proximal humerus fracture. These findings indicate that functional outcomes are acceptable to patients younger than ۷۰ in the short term, but more studies are needed. Patients should be counseled that the long-term durability of RSA performed for fracture in young, active patients remains unknown.

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نویسندگان

Derek Stenquist

Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, MA, USA

James Barger

Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, MA, USA

Amin Mohamadi

Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, USA

Michael Weaver

Division of Orthopaedic Trauma, Harvard Medical School, Brigham and Women’s Hospital, USA

Nishant Suneja

Orthopaedic Trauma Service, SUNY Downstate, Brooklyn, New York, USA

George S.M. Dyer

Harvard Combined Orthopaedic Residency, Harvard Medical School, Brigham and Women’s Hospital, MA, USA

Arvind Von Keudell

Orthopaedic Geriatric Trauma Surgery and Research, Harvard Medical School, Brigham and Women’s Hospital, MA, USA