Hawkins R J, Greis P E, Bonutti P M
Department of Orthopedics, University of Colorado, Denver, USA.
Orthopedics. 1999 Feb;22(2):229-34. doi: 10.3928/0147-7447-19990201-13.
Nine patients with symptomatic glenoid loosening were identified and ultimately underwent surgical revision. Preoperative assessment demonstrated that pain, decreased range of motion, and functional disability were common features. A painful clunking sensation with forward elevation of the arm was noted in four of the nine patients. At surgical revision, a grossly loose glenoid component was found in all cases and removed. Seven of the nine patients underwent revision using another cemented glenoid component, and two patients were left with a hemiarthroplasty due to glenoid bone deficiency. Results following revision surgery demonstrated increased range of motion, decreased pain, and increased functional ability with good overall patient satisfaction in seven of nine patients. Two patients in whom revision glenoid components were implanted were considered failures due to recurrent loosening. Although revision of the glenoid component is often technically feasible, recurrent loosening may occur. Revision to a hemiarthroplasty may be an acceptable alternative to glenoid replacement.
确定了9例有症状的盂肱关节松动患者，最终均接受了手术翻修。术前评估显示，疼痛、活动范围减小和功能障碍是常见特征。9例患者中有4例在手臂前举时出现疼痛性卡顿感。手术翻修时，所有病例均发现盂肱关节组件明显松动并予以取出。9例患者中有7例使用另一个骨水泥固定的盂肱关节组件进行翻修，2例因盂肱关节骨质缺损而接受了半关节置换术。翻修手术后的结果显示，9例患者中有7例活动范围增加、疼痛减轻、功能能力增强，患者总体满意度良好。2例植入翻修盂肱关节组件的患者因再次松动被视为手术失败。尽管盂肱关节组件的翻修在技术上通常可行，但仍可能发生再次松动。改为半关节置换术可能是盂肱关节置换的一个可接受的替代方案。
