Merolla Giovanni, Paladini Paolo, Campi Fabrizio, Porcellini Giuseppe
Unit of Shoulder and Elbow Surgery, Ospedale D. Cervesi, Via L. Van Beethoven 1, 47841 Cattolica (RN), Italy.
Chir Organi Mov. 2008 Feb;91(2):109-15. doi: 10.1007/s12306-007-0019-y. Epub 2008 Mar 3.
More than 32.8% of the over-60s suffer from shoulder osteoarthritis. For advanced osteoarthritis, arthroplasty is the treatment of choice. Current systems have moved on from the first shoulder prosthesis implanted by Neer in 1974, thanks to the use of adaptable modular systems. The aim of this study was to investigate the effectiveness of anatomical shoulder replacements in 30 cases of primary glenohumeral osteoarthritis through clinical and radiographic follow-up for a mean of 5 years. All implants were total cemented prostheses. Preoperative investigations included a clinical examination, conventional X-rays and CT. The Constant-Murley scale was used to evaluate the results; the mean score increased from 21.4 preoperative to 69.8 postoperative (p<0.05). In patients aged under 50, the increase in the mean postoperative Constant Score and ROM was greater than for the sample as a whole. The following complications were encountered: 2 postoperative radial nerve paralyses, resolving in 3 months, 2 cases of glenoid loosening, 1 periprosthetic fracture and 3 cases of pain and stiffness. The results led us to conclude that anatomical prostheses are effective in the treatment of severe primary glenohumeral arthropathy.
60岁以上人群中，超过32.8%患有肩部骨关节炎。对于晚期骨关节炎，关节成形术是首选治疗方法。由于采用了适应性模块化系统，目前的系统已从1974年Neer植入的首个肩部假体发展而来。本研究的目的是通过平均5年的临床和影像学随访，调查30例原发性盂肱关节骨关节炎患者中解剖型肩关节置换术的有效性。所有植入物均为全骨水泥假体。术前检查包括临床检查、传统X线和CT。采用Constant-Murley评分评估结果；平均得分从术前的21.4分提高到术后的69.8分（p<0.05）。在50岁以下的患者中，术后Constant评分和ROM的平均增加幅度大于整个样本。出现了以下并发症：2例术后桡神经麻痹，3个月内恢复；2例盂肱关节松动；1例假体周围骨折；3例疼痛和僵硬。结果使我们得出结论，解剖型假体在治疗严重原发性盂肱关节病方面是有效的。
