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初次反式肩关节置换术后肩胛盂基板失败的翻修反式肩关节置换术

Revision reverse shoulder arthroplasty for glenoid baseplate failure after primary reverse shoulder arthroplasty.

作者信息

Holcomb Jason O, Cuff Derek, Petersen Steve A, Pupello Derek R, Frankle Mark A

机构信息

Shoulder & Elbow Division, Florida Orthopaedic Institute, Tampa, FL 33637, USA.

出版信息

J Shoulder Elbow Surg. 2009 Sep-Oct;18(5):717-23. doi: 10.1016/j.jse.2008.11.017. Epub 2009 Mar 17.

Abstract

BACKGROUND

The aim of this study is to document a single surgeon's experience performing revision reverse shoulder arthroplasty after baseplate failure.

METHODS

Revision reverse shoulder arthroplasty (RSA) for mechanical failure of the glenoid baseplate after RSA was performed in 14 patients. Clinical and radiographic data were collected preoperatively, prior to baseplate failure, after baseplate failure, and at latest follow-up after revision (average, 33 months).

RESULTS

When comparing the pre-operative values to post-revision, ASES, forward elevation, and abduction were significantly improved. There was no significant difference in any of the outcome measures when comparing the prefailure data to the post-revision data. The post-revision prosthesis-scapular neck angle (PSNA) showed a significant increase in inferior tilt of the baseplate when compared to pre-failure PSNA (P < .001). Two patients (14%) required a second revision RSA for glenoid baseplate failure (1) and dislocation (1); 1 additional patient developed a postoperative hematoma which resolved without surgery.

CONCLUSION

Revision RSA for the treatment of glenoid baseplate mechanical failure can restore pain relief and function to the levels gained after the index RSA.

摘要

背景

本研究的目的是记录一位外科医生在肩胛盂基板失败后进行翻修反肩关节置换术的经验。

方法

对14例因肩胛盂基板机械性失败而进行翻修反肩关节置换术(RSA)的患者进行了研究。收集了术前、基板失败前、基板失败后以及翻修后最新随访(平均33个月)时的临床和影像学数据。

结果

将术前值与翻修后的值进行比较时,美国肩肘外科医师学会(ASES)评分、前屈抬高和外展均有显著改善。将失败前数据与翻修后数据进行比较时,任何一项结果指标均无显著差异。与失败前的假体-肩胛颈角度(PSNA)相比,翻修后的PSNA显示基板的下倾显著增加(P < 0.001)。两名患者(14%)因肩胛盂基板失败(1例)和脱位(1例)需要进行第二次翻修RSA;另有1例患者出现术后血肿,未经手术自行消退。

结论

用于治疗肩胛盂基板机械性失败的翻修RSA可将疼痛缓解和功能恢复到初次RSA后的水平。

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