Cofield R H
Department of Orthopedic Surgery, Mayo Clinic and Foundation, Rochester, MN.
Semin Arthroplasty. 1990 Oct;1(2):112-23.
Total shoulder arthroplasty has advanced beyond addressing only the techniques of implant placement. To improve clinical results and assure maximum implant longevity, the surgeon needs to address soft tissue contractures, soft tissue deficiencies, glenohumeral instability, and bone deficiencies with a number and often a combination of surgical maneuvers. These techniques include excision of abnormal tissue, division of adhesions, selective tissue releases, variation in bone osteotomy or preparation to modify implant position, use of a variety of standard implants or custom devices, and supplementation of certain tissue deficiencies with autologous or allograft tissues. When the reconstruction is completed, the surgeon needs to assess movement, stability, and strength of the supporting tissues to plan an optimal rehabilitation program.
全肩关节置换术已经超越了仅仅解决植入物放置技术的范畴。为了改善临床效果并确保植入物的最长使用寿命，外科医生需要通过一系列手术操作，常常是多种操作的组合，来解决软组织挛缩、软组织缺损、盂肱关节不稳和骨缺损等问题。这些技术包括切除异常组织、松解粘连、选择性组织松解、改变截骨或骨准备方式以调整植入物位置、使用各种标准植入物或定制器械，以及用自体或同种异体组织补充某些组织缺损。重建完成后，外科医生需要评估支撑组织的活动度、稳定性和强度，以制定最佳的康复计划。
