Отказ от использования повязки после замены плечевого сустава не ухудшает восстановление

Discontinuing sling use directly after shoulder arthroplasty may not compromise recovery Key takeaways: - Interim results found no significant differences in patients who wore slings for 6 weeks and those who discontinued use. - Further research is required to determine if similarities persist beyond 9 months. SEATTLE — Interim results presented at the American Orthopaedic Society for Sports Medicine Annual Meeting show allowing patients to discontinue sling use right after reverse shoulder arthroplasty did not compromise short-term recovery. “Historically, the sling has been used to protect the shoulder during early healing, but there is not a clear consensus on how long these patients need to remain immobilized,” Sophia McMahon, a medical student at Temple University’s Lewis Katz School of Medicine, told Healio. “Our results suggest that strict prolonged immobilization may not be necessary for every patient following primary reverse shoulder arthroplasty, and physicians may be able to give patients more freedom during their early recovery without compromising their short-term clinical outcomes.” In a prospective, single-blinded controlled trial, McMahon and colleagues compared patients who wore a sling following reverse shoulder arthroplasty and patients who were allowed to remove the sling at their own discretion once their regional nerve block resolved. Researchers randomly assigned 50 patients to the sling group, who were instructed to wear the sling for 6 weeks, and 50 patients to the sling-for-comfort group, with patients matched based on age, gender and surgical indication for analysis. Collected data across a 9-month average follow-up period included preoperative and postoperative range of motion scores, patient-reported outcomes, and clinical and radiographic complications. According to McMahon, the 3-month timepoint held specific significance, as many reverse shoulder arthroplasty complications tend to occur in the early postoperative period. Researchers found no significant differences in demographics, forward flexion, external rotation, internal rotation, subjective shoulder value and visual analog score with no observable complications in the 70 patients who met inclusion criteria. McMahon and colleagues noted the potential benefits of a relaxed sling protocol for patients who are older or live alone. “Slings can be very burdensome, especially for an older patient,” McMahon said. “They can make basic activities like dressing, bathing and sleeping more difficult, and there is also evidence suggesting that sling immobilization can negatively affect balance and gait.” McMahon said that despite the initial results finding no observable differences, a longer follow-up period is necessary to determine if the similarity between sling and sling-for-comfort groups persist beyond the immediate postoperative period. Researchers will also assess sling practices and compliance, patient-reported outcomes and functional outcomes at study completion. “If our longer-term data continue to support these findings, it could allow surgeons to individualize postoperative protocols and potentially let appropriate patients use the sling for comfort rather than requiring strict immobilization for 6 weeks, which could ultimately give patients more freedom and independence during their early recovery without sacrificing their clinical outcomes,” McMahon told Healio. For more information: Sophia McMahon can be contacted at [email protected]; https://www.linkedin.com/in/sophia-mcmahon-6913301b2.