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Patients with poor early clinical outcomes after anatomic total shoulder arthroplasty have sustained poor performance at 2 years from surgery.
- Source :
-
European Journal of Orthopaedic Surgery & Traumatology . Dec2023, Vol. 33 Issue 8, p3661-3669. 9p. - Publication Year :
- 2023
-
Abstract
- Purpose: We sought to define the risk of persistent shoulder dysfunction after anatomic total shoulder arthroplasty (aTSA) beyond the early postoperative period and identify risk factors for persistent poor performance. Methods: We retrospectively identified 144 primary aTSAs performed for primary osteoarthritis with early poor performance and 2-year minimum follow-up. Early poor performance was defined as a postoperative ASES score below the 20th percentile at 3- or 6-months (62 and 72 points, respectively). Persistent poor performance at 2 years was defined as failing to achieve the patient acceptable symptomatic state (PASS) [ASES = 81.7 points]. Results: At 2-year follow-up, 51% (n = 74) of patients with early poor performance at either 3- or 6-month follow-up had persistent poor performance. There was no difference in the rate of persistent poor performance if patients were poor performers at the 3-, 6-month follow-up, or both (50% vs. 49% vs. 56%, P =.795). Of aTSAs achieving the PASS at 2-year follow-up, a greater proportion exceeded the minimal clinically important differences (MCID) [Forward elevation, external rotation, and all outcome scores] and substantial clinical benefit (SCB) [external rotation and all outcome scores] compared to persistent poor performers. However, over half of persistent poor performers still exceeded the MCID for all outcome measures (56–85%). Independent predictors of persistent poor performance were hypertension (2.61 [1.01–6.72], P =.044) and diabetes (5.14 [1.00–26.4], P =.039). Conclusion: Over half of aTSAs with an ASES score < 20th percentile at early follow-up had continued poor shoulder function at 2-years postoperatively. Persistent poor performance was best projected by preoperative hypertension and diabetes. Level of evidence: Level III; Retrospective Cohort Comparison using Large Database; Treatment Study [ABSTRACT FROM AUTHOR]
- Subjects :
- *SHOULDER joint surgery
*HYPERTENSION
*SHOULDER joint
*RANGE of motion of joints
*FUNCTIONAL status
*TIME
*SURGICAL complications
*RETROSPECTIVE studies
*DIABETES
*TREATMENT effectiveness
*RISK assessment
*FUNCTIONAL assessment
*BODY movement
*DESCRIPTIVE statistics
*DATA analysis software
*TOTAL shoulder replacement
Subjects
Details
- Language :
- English
- ISSN :
- 16338065
- Volume :
- 33
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- European Journal of Orthopaedic Surgery & Traumatology
- Publication Type :
- Academic Journal
- Accession number :
- 173628261
- Full Text :
- https://doi.org/10.1007/s00590-023-03585-z