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肩关节翻修术:适应证与疗效分析。

Revision shoulder arthroplasty: an analysis of indications and outcomes.

机构信息

Kentucky Bone & Joint Surgeons, Lexington, KY40504, USA.

出版信息

J Shoulder Elbow Surg. 2010 Mar;19(2):308-13. doi: 10.1016/j.jse.2009.05.016. Epub 2009 Sep 3.

Abstract

BACKGROUND

We reviewed all revision operations performed by a single surgeon on previous hemi- and total shoulder arthroplasties from November 1987 to March 2005.

METHOD

Thirty-five patients' charts were reviewed to determine the causes of failures. In addition, their outcomes after the revision surgery were analyzed.

RESULTS

Overall, results were satisfactory in 71% by Neer criteria at a mean follow-up of 27.6 months. Outcomes were related to reason for failure. When failure was because of glenoid erosion, loosening, or humeral loosening, the mean improvement in forward elevation (FE) (28.9 degrees ) and external rotation (ER) (16.1 degrees ) was significantly better (P=.024 FE; P=.000 ER) than when the failure was because of infection, soft-tissue problems, or pain of undetermined origin (FE=-5.6 degrees ; ER=-6.8 degrees ).Likewise, UCLA scores in the first group were significantly better than in the second group (P=.003). In the first group, 16/18 patients were satisfied, while in the second group only 4/17 were satisfied.

CONCLUSION

Our data suggest that patients whose revisions are because of glenoid erosion or component loosening can expect to have better outcomes than those whose revisions are performed for infection, instability, or other soft-tissue problems.

摘要

背景

我们回顾了 1987 年 11 月至 2005 年 3 月期间一位外科医生对先前的半肩和全肩关节置换术进行的所有翻修手术。

方法

回顾了 35 名患者的病历,以确定失败的原因。此外,还分析了他们翻修手术后的结果。

结果

总体而言,根据 Neer 标准,71%的患者在平均 27.6 个月的随访中结果满意。结果与失败原因有关。当失败是由于肩胛盂侵蚀、松动或肱骨松动时,前伸(FE)(28.9 度)和外旋(ER)(16.1 度)的平均改善明显更好(P=.024 FE;P=.000 ER),而当失败是由于感染、软组织问题或原因不明的疼痛时,FE=-5.6 度;ER=-6.8 度)。同样,第一组的 UCLA 评分明显优于第二组(P=.003)。在第一组中,18 名患者中有 16 名满意,而在第二组中,只有 17 名患者中有 4 名满意。

结论

我们的数据表明,因肩胛盂侵蚀或组件松动而接受翻修的患者的结果可能比因感染、不稳定或其他软组织问题而接受翻修的患者要好。

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