Sanchez-Sotelo J, O'Driscoll S W, Torchia M E, Cofield R H, Rowland C M
Department of Orthopedic Surgery, Mayo Clinic Rochester, MN 55905, USA.
J Shoulder Elbow Surg. 2001 Nov-Dec;10(6):526-31. doi: 10.1067/mse.2001.118482.
Forty-three shoulder arthroplasties performed with the use of cemented Neer II humeral components and followed radiographically for a mean of 6.6 years (range, 2-20 years) were analyzed. A humeral component was considered radiographically "at risk" for clinical loosening when a radiolucent line 2 mm or greater in width was present in 3 or more zones or tilt or subsidence was identified on sequential radiographs by 2 or 3 of the 3 independent observers. None of the components was considered to have tilted or subsided. Radiolucent lines of any size were present in 16 shoulders and were wider than 2 mm in 9 shoulders. They were limited to 1 zone in 8 shoulders and to 2 zones in 7 shoulders. Only 1 component (2%) with a 2-mm radiolucent line in 3 zones was judged to be "at risk." The incidence, extent, and thickness of humeral radiolucent lines were significantly higher in total arthroplasties than in hemiarthroplasties (P <.05). Clinically important changes around cemented Neer II humeral components are uncommon. Humeral radiolucent lines develop more frequently in the presence of a glenoid component. Data from this study can be used as one benchmark to compare with alternate methods of humeral component fixation.
对43例使用骨水泥型Neer II型肱骨假体进行的肩关节置换术进行了分析，这些病例均进行了平均6.6年（范围2 - 20年）的影像学随访。当3个或更多区域出现宽度达2毫米或更宽的透亮线，或3名独立观察者中的2名或3名在连续X线片上发现假体倾斜或下沉时，该肱骨假体在影像学上被认为有临床松动“风险”。所有假体均未出现倾斜或下沉。16例肩关节出现了任何大小的透亮线，9例肩关节的透亮线宽度超过2毫米。其中，8例肩关节的透亮线局限于1个区域，7例肩关节的透亮线局限于2个区域。只有1个假体（2%）在3个区域出现了2毫米宽的透亮线，被判定为有“风险”。全肩关节置换术中肱骨透亮线的发生率、范围和厚度显著高于半肩关节置换术（P <.05）。骨水泥型Neer II型肱骨假体周围出现具有临床意义的改变并不常见。在存在肩胛盂假体的情况下，肱骨透亮线更易出现。本研究的数据可作为一个基准，用于与肱骨假体固定的其他方法进行比较。
