Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
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Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty

  • Troy Li (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Akiro H. Duey (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Christopher A. White (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Amit Pujari (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Akshar V. Patel (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Bashar Zaidat (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Christine S. Williams (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Alexis Williams (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Carl M. Cirino (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Dave Shukla (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Bradford O. Parsons (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Evan L. Flatow (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai) ;
  • Paul J. Cagle (Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai)
  • 투고 : 2023.05.18
  • 심사 : 2023.06.26
  • 발행 : 2023.09.01
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초록

Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA. Methods: Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival. Results: At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure. Conclusions: When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.

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참고문헌

  1. Gazielly DF, Scarlat MM, Verborgt O. Long-term survival of the glenoid components in total shoulder replacement for arthritis. Int Orthop 2015;39:285-9. 
  2. Neyton L, Kirsch JM, Collotte P, et al. Mid-to long-term follow-up of shoulder arthroplasty for primary glenohumeral osteoarthritis in patients aged 60 or under. J Shoulder Elbow Surg 2019;28:1666-73. 
  3. Neer CS 2nd, Watson KC, Stanton FJ. Recent experience in total shoulder replacement. J Bone Joint Surg Am 1982;64:319-37. 
  4. Betts HM, Abu-Rajab R, Nunn T, Brooksbank AJ. Total shoulder replacement in rheumatoid disease: a 16- to 23-year follow-up. J Bone Joint Surg Br 2009;91:1197-200. 
  5. Sirveaux F, Roche O, Mole D. Shoulder arthroplasty for acute proximal humerus fracture. Orthop Traumatol Surg Res 2010;96:683-94. 
  6. Mattei L, Mortera S, Arrigoni C, Castoldi F. Anatomic shoulder arthroplasty: an update on indications, technique, results and complication rates. Joints 2015;3:72-7. 
  7. Sanchez-Sotelo J. Total shoulder arthroplasty. Open Orthop J 2011;5:106-14. 
  8. Wagner ER, Farley KX, Higgins I, Wilson JM, Daly CA, Gottschalk MB. The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg 2020;29:2601-9. 
  9. Anakwenze OA, Yehyawi T, Dillon MT, Paxton E, Navarro R, Singh A. Effect of age on outcomes of shoulder arthroplasty. Perm J 2017;21:16-056. 
  10. Jensen AR, Tangtiphaiboontana J, Marigi E, Mallett KE, Sperling JW, Sanchez-Sotelo J. Anatomic total shoulder arthroplasty for primary glenohumeral osteoarthritis is associated with excellent outcomes and low revision rates in the elderly. J Shoulder Elbow Surg 2021;30:S131-9. 
  11. Iriberri I, Candrian C, Freehill MT, Raiss P, Boileau P, Walch G. Anatomic shoulder replacement for primary osteoarthritis in patients over 80 years: outcome is as good as in younger patients. Acta Orthop 2015;86:298-302. 
  12. Foruria AM, Sperling JW, Ankem HK, Oh LS, Cofield RH. Total shoulder replacement for osteoarthritis in patients 80 years of age and older. J Bone Joint Surg Br 2010;92:970-4. 
  13. Padegimas EM, Maltenfort M, Lazarus MD, Ramsey ML, Williams GR, Namdari S. Future patient demand for shoulder arthroplasty by younger patients: national projections. Clin Orthop Relat Res 2015;473:1860-7. 
  14. Davies A, Lloyd T, Sabharwal S, Liddle AD, Reilly P. Anatomical shoulder replacements in young patients: a systematic review and meta-analysis. Shoulder Elbow 2022 Feb 3 [Epub]. https://doi.org/10.1177/17585732221075037 
  15. Raiss P, Aldinger PR, Kasten P, Rickert M, Loew M. Total shoulder replacement in young and middle-aged patients with glenohumeral osteoarthritis. J Bone Joint Surg Br 2008;90:764-9. 
  16. Garcia GH, Liu JN, Sinatro A, et al. High satisfaction and return to sports after total shoulder arthroplasty in patients aged 55 years and younger. Am J Sports Med 2017;45:1664-69. 
  17. Bartelt R, Sperling JW, Schleck CD, Cofield RH. Shoulder arthroplasty in patients aged fifty-five years or younger with osteoarthritis. J Shoulder Elbow Surg 2011;20:123-30. 
  18. Brewley EE Jr, Christmas KN, Gorman RA 2nd, Downes KL, Mighell MA, Frankle MA. Defining the younger patient: age as a predictive factor for outcomes in shoulder arthroplasty. J Shoulder Elbow Surg 2020;29:S1-8. 
  19. Sperling JW, Cofield RH, Rowland CM. Neer hemiarthroplasty and Neer total shoulder arthroplasty in patients fifty years old or less: long-term results. J Bone Joint Surg Am 1998;80:464-73. 
  20. Patel RB, Muh S, Okoroha KR, et al. Results of total shoulder arthroplasty in patients aged 55 years or younger versus those older than 55 years: an analysis of 1135 patients with over 2 years of follow-up. J Shoulder Elbow Surg 2019;28:861-8. 
  21. Dillon MT, Inacio MC, Burke MF, Navarro RA, Yian EH. Shoulder arthroplasty in patients 59 years of age and younger. J Shoulder Elbow Surg 2013;22:1338-44. 
  22. Wagner ER, Houdek MT, Schleck CD, et al. The role age plays in the outcomes and complications of shoulder arthroplasty. J Shoulder Elbow Surg 2017;26:1573-80. 
  23. Shimada Y, Takahashi N, Sugaya H, et al. Clinical outcomes of anatomic total shoulder arthroplasty for primary shoulder osteoarthritis did not differ between elderly and younger Japanese patients. JSES Rev Rep Tech 2021;1:361-6. 
  24. Amroodi MN, Behshad V, Motaghi P. Long-term results, functional outcomes and complications after open reduction and internal fixation of neglected and displaced greater tuberosity of humerus fractures. Arch Bone Jt Surg 2016;4:330-6. 
  25. Pandya J, Johnson T, Low AK. Shoulder replacement for osteoarthritis: a review of surgical management. Maturitas 2018;108:71-6. 
  26. Golant A, Christoforou D, Zuckerman JD, Kwon YW. Return to sports after shoulder arthroplasty: a survey of surgeons' preferences. J Shoulder Elbow Surg 2012;21:554-60. 
  27. Izquierdo R, Voloshin I, Edwards S, et al. Treatment of glenohumeral osteoarthritis. J Am Acad Orthop Surg 2010;18:375-82. 
  28. Lo IK, Litchfield RB, Griffin S, Faber K, Patterson SD, Kirkley A. Quality-of-life outcome following hemiarthroplasty or total shoulder arthroplasty in patients with osteoarthritis: a prospective, randomized trial. J Bone Joint Surg Am 2005;87:2178-85. 
  29. Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg 2002;11:130-5. 
  30. Singh JA, Sperling JW, Cofield RH. Revision surgery following total shoulder arthroplasty: analysis of 2588 shoulders over three decades (1976 to 2008). J Bone Joint Surg Br 2011;93:1513-7. 
  31. Baumgarten KM, Chang PS, Dannenbring TM, Foley EK. Does total shoulder arthroplasty improve patients' activity levels. J Shoulder Elbow Surg 2018;27:1987-95. 
  32. Johnson MH, Paxton ES, Green A. Shoulder arthroplasty options in young (< 50 years old) patients: review of current concepts. J Shoulder Elbow Surg 2015;24:317-25. 
  33. Lowe JT, Menendez ME, Dasti U, et al. Patient age affects expectations and outcomes in primary total shoulder arthroplasty for glenohumeral osteoarthritis. Semin Arthroplasty 2020;30:50-5. 
  34. Henn RF 3rd, Ghomrawi H, Rutledge JR, Mazumdar M, Mancuso CA, Marx RG. Preoperative patient expectations of total shoulder arthroplasty. J Bone Joint Surg Am 2011;93:2110-5.