Journal of shoulder and elbow surgery · 2025
Anatomic total shoulder arthroplasty indications, outcomes, and survivorship in patients younger than 50 years of age: a systematic review.
СтатьяСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Peebles Liam A, Akamefula Ramesses A, Weinerman Jonathan, DeFoor Mikalyn T, Dekker Travis J
Аннотация
BACKGROUND: Although prior studies have raised concern regarding the longevity of anatomic total shoulder arthroplasty (aTSA) in young and active patients, it remains an effective treatment option for this population commonly presenting with multifactorial etiologies of shoulder arthritis. The purpose of this study was to perform a systematic review evaluating aTSA indications, outcomes, and implant survivorship in young and active patients aged 50 years or less.
METHODS: A systematic review of the literature from 1980 to 2024 evaluating outcomes following aTSA in patients less than 50 years of age was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, indications for aTSA, and the number of prior shoulder surgeries were recorded when available. Outcomes included implant survivorship, revision and complication rates, indications for revision, preoperative and postoperative range of motion, as well as patient-reported outcome scores.
RESULTS: The literature search identified 814 articles, and 9 studies met the final inclusion criteria following full-text review. A total of 173 patients (184 shoulders) were assessed across the included studies, and the mean age ranged from 33.3 to 44.2 years old. Average duration of clinical and radiographic follow-up ranged from 2.3 to 22.0 years. The most common indications for aTSA were glenohumeral osteoarthritis (37.5%) and rheumatoid arthritis (35.8%), followed by post-traumatic arthritis (8.5%), chondrolysis (7.4%), avascular necrosis (6.3%), and other (4.5%). Revision rate ranged from 3.8% (1/26 at 2.3 years) to 41.2% (7/17 at 14.5 years). Implant survivorship ranged from 80 to 100%, 95 to 100% at 0-10 years, 71% to 84% at 11-15 years, and 61% to 64% at >15 years. The most commonly reported outcome scores were the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and the visual analog scale for pain. Forward flexion increased by a mean 32° (range, 12° to 51°), abduction increased by 41° (range, 26° to 64°), and external rotation increased by 22° (range, 14° to 26°) at the final follow-up CONCLUSION: In young patients under the age of 50 years, aTSA is a reliable option for restoring shoulder function and range of motion with low revision rates and high implant survivorship at short- to mid-term follow-up. The most common indications for aTSA were glenohumeral osteoarthritis and rheumatoid arthritis. Compared to older patients, those under 50 may expect moderately inferior functional outcomes and long-term.
METHODS: A systematic review of the literature from 1980 to 2024 evaluating outcomes following aTSA in patients less than 50 years of age was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, indications for aTSA, and the number of prior shoulder surgeries were recorded when available. Outcomes included implant survivorship, revision and complication rates, indications for revision, preoperative and postoperative range of motion, as well as patient-reported outcome scores.
RESULTS: The literature search identified 814 articles, and 9 studies met the final inclusion criteria following full-text review. A total of 173 patients (184 shoulders) were assessed across the included studies, and the mean age ranged from 33.3 to 44.2 years old. Average duration of clinical and radiographic follow-up ranged from 2.3 to 22.0 years. The most common indications for aTSA were glenohumeral osteoarthritis (37.5%) and rheumatoid arthritis (35.8%), followed by post-traumatic arthritis (8.5%), chondrolysis (7.4%), avascular necrosis (6.3%), and other (4.5%). Revision rate ranged from 3.8% (1/26 at 2.3 years) to 41.2% (7/17 at 14.5 years). Implant survivorship ranged from 80 to 100%, 95 to 100% at 0-10 years, 71% to 84% at 11-15 years, and 61% to 64% at >15 years. The most commonly reported outcome scores were the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, and the visual analog scale for pain. Forward flexion increased by a mean 32° (range, 12° to 51°), abduction increased by 41° (range, 26° to 64°), and external rotation increased by 22° (range, 14° to 26°) at the final follow-up CONCLUSION: In young patients under the age of 50 years, aTSA is a reliable option for restoring shoulder function and range of motion with low revision rates and high implant survivorship at short- to mid-term follow-up. The most common indications for aTSA were glenohumeral osteoarthritis and rheumatoid arthritis. Compared to older patients, those under 50 may expect moderately inferior functional outcomes and long-term.