QUALITY OF LIFE IN PATIENTS WHO HAVE UNDERGONE REVERSE SHOULDER ARTHROPLASTY

ABSTRACT Objective: To evaluate the health-related quality of life (HRQoL) of patients who have undergone reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy (RCA). Methods: A retrospective study with 35 patients who underwent RSA from August 2007 to July 2015. We collected clinical data and applied the 36-item Short Form Health Survey (SF-36). Results: Of the 35 patients, 29 (82.9%) were female, and mean age was 75.71 years, ranging from 50 to 89 years. The dominant side was frequently affected (68.6%), and most of the cases were Hamada type 3 (57.1%). The Mackenzie approach was used in 30 patients (85.7%). Physical and mental HRQoL was not associated with severity of RCA before RSA. Lower scores for Physical Functioning, Role Physical, Bodily Pain, and Physical Component Summary (PCS) were associated with other orthopedic comorbidities. Vitality, Role Emotional, Mental Health, and Mental Component Summary (MCS) were significantly higher in patients without depression. Orthopedic comorbidity and depression predicted lower PCS and longer follow-up time predicted better PCS scores. Depression was also a predictor of the MCS. Conclusion: Patients who had undergone RSA for RCA had good HRQoL. Longer follow-up time was associated with better HRQoL. Good results were maintained over the follow-up period. Level of evidence II, retrospective study.

摘要
研究目的：评估因肩袖关节病（rotator cuff arthropathy, RCA）接受反向肩关节置换术（reverse shoulder arthroplasty, RSA）的患者的健康相关生活质量（health-related quality of life, HRQoL）。
研究方法：本研究为回顾性研究，纳入2007年8月至2015年7月期间接受RSA治疗的35例患者，收集其临床资料并采用36条目简明健康调查问卷（36-item Short Form Health Survey, SF-36）进行评估。
研究结果：共纳入35例患者，其中29例（82.9%）为女性，平均年龄75.71岁，年龄范围50~89岁。优势侧肩部受累者占比68.6%，多数病例为Hamada 3型（57.1%）。30例患者（85.7%）采用Mackenzie手术入路。术前RCA的严重程度与患者的躯体及精神健康相关生活质量均无显著关联。合并其他骨科合并症的患者，其躯体功能、躯体角色功能、躯体疼痛及躯体成分总结（Physical Component Summary, PCS）得分更低。无抑郁症状的患者，其活力、情绪角色功能、精神健康及精神成分总结（Mental Component Summary, MCS）得分显著更高。骨科合并症与抑郁可预测更低的PCS得分，而更长的随访时间则与更高的PCS得分相关。抑郁同样是MCS得分的预测因素。
研究结论：因肩袖关节病接受RSA治疗的患者具有良好的健康相关生活质量。更长的随访时间与更优的健康相关生活质量相关，且随访期间疗效维持良好。本研究证据等级为II级，属于回顾性研究。