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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 10-Year Follow-up
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Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 10-Year Follow-up

机译：养生和患者报告的Glenohumeral骨关节炎的综合关节镜管理后的结果：最短的10年后续随访

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Objectives: Glenohumeral osteoarthritis (GHOA) remains a common cause of shoulder pain, loss of shoulder range of motion, and upper extremity dysfunction. Few long-term outcome studies exist evaluating glenohumeral osteoarthritis (GHOA) treatment with arthroscopic management. The purpose of this study was to determine outcomes, risk factors for failure, and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at minimum 10-year follow-up. It was hypothesized that while some patients would progress to total shoulder arthroplasty (TSA), the majority of patients would demonstrate sustained improvement in patient-reported outcomes and satisfaction without conversion to TSA at long term follow-up. Methods: The CAM procedure was performed on a consecutive series of patients with advanced GHOA who opted for joint preservation surgery that otherwise met criteria for total shoulder arthroplasty (TSA). At minimum 10-year follow-up, pre- and post-operative outcome measures collected included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to arthroplasty. Results: Thirty-eight CAM procedures were performed with 10-year minimum follow-up (range, 10-14 years) with a mean age of 53 years (range, 27-68) at time of surgery. Kaplan Meier survivorship curve showing 75.3% CAM survivorship (Comprehensive Arthroscopic Management) for glenohumeral arthritis at 5 years and 63.2% at 10 years in Figure 1. Those who progressed to arthroplasty did so at a mean of 4.7 years (range, 0.8-9.6 years). For those who did not undergo arthroplasty, ASES scores significantly improved post-operatively at both 5 and 10 years (63.3-89.6, p&0.001; 63.3-80.6, p=.007) (Table 1). CAM failure was associated with severe pre-operative humeral head incongruity in 93.8% of failures compared to 50.0.% of patients who did not go onto arthroplasty (p= 0.008). Median satisfaction was 7.5 out of 10. Conclusions: Significant improvement in patient reported outcomes were sustained at minimum 10-year follow-up in young patients with GHOA who underwent a CAM procedure. Survivorship rate at minimum 10-year follow-up was 63.2%. Humeral head flattening and severe joint incongruity were risk factors for CAM failure. The CAM procedure is an effective joint preserving treatment for GHOA in appropriately selected patients with sustained positive outcomes at 10 years.
机译：目的：胶质肿瘤骨关节炎（Ghoa）仍然是肩痛的常见原因，肩部损失，运动范围和上肢功能障碍。少数长期结果研究存在评估胶质肿瘤骨关节炎（GHOA）治疗与关节镜检查。本研究的目的是确定成果，失败的危险因素，以及综合关节镜管理（CAM）程序的生存率，以至少为10年的随访治疗GHOA。假设，虽然一些患者将进展到总肩部关节置换术（TSA），但大多数患者将表现出患者报告的结果和满意度的持续改善，而不会转换为长期随访的TSA。方法：凸轮程序是在连续系列的高级GHOA患者上进行，他们选择了联合保护手术，否则符合总肩部关节置换术（TSA）的标准。至少10年后的后续行动，收集的后期和后期结果措施包括美国肩部和肘部外科医生（ASES），单一评估数字评估（SANE），手臂，肩部和手的快速残疾（QuickDash），简短的FORM-12（SF-12）物理组件摘要（PC），疼痛的视觉模拟规模和满意度分数。 Kaplan-Meier生存分析是由于患有关节成形术而被定义为进展的故障。结果：在手术时，三十八个凸轮程序以10年的最低随访（范围，10-14岁），平均年龄为53岁（范围，27-68）。 Kaplan Meier生存曲线显示75.3％的凸轮生存（综合关节镜管理）在5年内为胶质瘤性关节炎，63.2％在图1.上达到关节成形术的人以平均为4.7岁（范围，0.8-9.6岁）。对于那些没有接受关节成形术的人，ASES分数在5和10年后可操作地显着改善（63.3-89.6，P＆amp; 0.001; 63.3-80.6，P = .007）（表1）。凸轮故障与严重的锻造肱骨头尿素有关93.8％的故障，而失败相比为50.0.0.0％。没有进入关节造身术的患者（P = 0.008）。中位数满意度为7.5分。结论：患者报告的结果的显着改善是在患有CAM程序的Ghoa的年轻患者的最低患者中持续了10年。至少10年后的救生率为63.2％。肱骨头部平坦和严重的关节肉质不协调是凸轮衰竭的危险因素。 The CAM procedure is an effective joint preserving treatment for GHOA in appropriately selected patients with sustained positive outcomes at 10 years.

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