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The Archives of Bone and Joint Surgery، جلد ۱۱، شماره ۳، صفحات ۰-۰
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عنوان انگلیسی A Comparison of Complications and Survivorship after Reverse Total Shoulder Arthroplasty for Proximal Humerus Fracture compared with Cuff Tear Arthropathy
چکیده انگلیسی مقاله Objectives: Traditionally used to treat rotator cuff tear arthropathy (CTA), reverse total shoulder arthroplasty (RTSA) is becoming increasingly utilized for the treatment of proximal humeral fractures (PHF). The purpose of this study was to use a matched cohort analysis to assess differences in 90 -day complications as well as 2-year and 5-year implant survival between patients undergoing RTSA for CTA and patients undergoing RTSA for PHF.Methods: Patients with at least a 5-year follow-up who underwent primary RTSA for either PHF or CTA were identified in a national database (PearlDiver Technologies) using current procedural terminology (CPT) and international classification of diseases (ICD) 9 and 10 codes. Patients with a surgical indication of PHF were matched with patients with a surgical indication of CTA based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index (BMI)>30). All-cause revision at the 2-year and 5-year postoperative time intervals were assessed. Reimbursements for the surgical care episode up to the 30-day, 90-day, and 1-year postoperative intervals were also assessed. Bivariate analysis was performed with a significance set at P< 0.05.Results: In total, 802 PHF patients were matched with 802 CTA patients. Compared to CTA patients, PHF patients undergoing RTSA were significantly at increased risk of atrial fibrillation, anemia, and heart failure within 90 days of surgery. Notably, there was no significant difference in all-cause revision surgery at 2-year and 5-year postoperative intervals or hospital reimbursements at the 30-day, 90-day, and 1-year postoperative intervals. Conclusion: Preoperative indication appears to be an important driver of healthcare utilization for RTSA, as PHF patients undergoing RTSA have a higher risk of short-term postoperative complications compared to CTA patients. However, there is no difference in hospital reimbursement for the two indications of RTSA, suggesting that current payment modalities may not appropriately adjust for risk based on the surgical indication. Level of evidence: III
کلیدواژه‌های انگلیسی مقاله CTA, PHF, reverse total shoulder arthroplasty, RTSA, proximal humeral fractures, rotator cuff tear arthropathy, surgical indications
نویسندگان مقاله | Kevin Wang
Johns Hopkins Department of Orthopedic Surgery, Charter Drive, Columbia, USA


| Amil Agarwal
Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington DC, USA


| Matthew Best
Massachusetts General Hospital, Department of Orthopedic Surgery, Boston, MA, USA


| John Mawn
Johns Hopkins Department of Orthopedic Surgery, Charter Drive, Columbia, USA


| Pramod Kamalapathy
Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, USA


| Uma. Srikumaran
Johns Hopkins Department of Orthopedic Surgery, Charter Drive, Columbia, USA
نشانی اینترنتی https://abjs.mums.ac.ir/article_21900.html
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نوع مقاله منتشر شده RESEARCH PAPER
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