Functional deficiencies following reverse and anatomic total shoulder arthroplasty: detecting true differences
Notice bibliographique
Résumé
Background Reverse total shoulder arthroplasty (rTSA) has gained traction as a reliable treatment option for glenohumeral osteoarthritis (GHOA). Much of this pivot from anatomic total shoulder arthroplasty (aTSA) to rTSA has centered on the described lower revision rates in the latter, as well as the reported equivalence in composite patient-reported outcomes between the two modes of TSA. Yet, this fails to highlight the nuanced effects each can have on everyday activities. This retrospective study aims to identify specific tasks that remain difficult for patients after TSA for GHOA and assess the difference in ability to perform specific daily tasks between aTSA and rTSA for GHOA. Methods Patients with minimum 2-year follow-up after undergoing TSA for GHOA were identified from a single-institution registry. Patient-reported outcome data from the American Shoulder and Elbow Surgeons (ASES), Western Ontario Osteoarthritis of the Shoulder (WOOS) index, and Single Assessment Numeric Evaluation surveys were collected at 2-year follow-up. Composite scores as well as each individual component score were compared between the two arthroplasty types by univariate analysis . When a difference in a component was found, further analysis was performed using multivariate linear regression (WOOS) or a multivariate logistic regression (ASES), while controlling for potential confounding variables. All analyses were performed in SPSS (version 28.0; IBM; Armonk, NY, USA). Results 317 TSAs were identified with two-year follow-up (mean age 67.2 years, 53.9% males), with 219 being anatomic TSA (69.1%). Postoperatively, there was gross improvement in visual analog scale pain ( P < .001) and ASES scores ( P < .001), with improvements noted in each ASES functional component ( P < .001). No differences were noted in all composite survey scores between aTSA and rTSA ( P > .15). Across the entire cohort, there was continued difficulty with behind-the-back and overhead activities. While rTSA patients reported better postoperative stiffness ( P = .02), they also noted more difficulty in tasks including washing their backs/doing up a bra (ASES, P = .001), tucking in a shirt (WOOS, P = .01), styling hair (WOOS, P = .02) and lifting 4.54 kg (10 lbs) above shoulder level (ASES, P = .001). Even when adjusting for confounding variables, rTSA was an independent predictor for decreased ability to tuck in shirt (WOOS, P < .001) and put on a coat (ASES; P = .03) Conclusion This study illustrates the subtle differences in postoperative function in patients treated with aTSA versus rTSA for GHOA, most notably in overhead and behind-the-back activities. This knowledge provides surgeons and patients with greater understanding of the true differences in anticipated outcomes between anatomic and reverse TSA for the treatment of GHOA.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».