William Beaumont Hospital Department of Orthopaedic Surgery, Royal Oak, MI, USA.
J Shoulder Elbow Surg. 2011 Jun;20(4):571-6. doi: 10.1016/j.jse.2010.08.024. Epub 2010 Dec 16.
Scapular notching is a well-recognized complication of reverse total shoulder arthroplasty (RTSA). This paper analyzes the effects of prosthesis design on scapular notching in RTSA.
From a database of all RTSA performed by the senior author, shoulders with minimum 12-month follow-up were included (65 shoulders). Notching in shoulders with a prosthesis neck-shaft angle of 155° and no center-of-rotation (COR) offset (group 1) was compared to notching in shoulders with a neck-shaft angle of 143° and 2.5-mm COR offset (group 2). P values less than .05 were considered significant.
The notching grade was significantly higher in group 1 than in group 2, even after statistically adjusting for differences in length of follow-up (P = .0081). The incidence of notching in group 1 at 60.7% was significantly higher than the 16.2% incidence in group 2 (P = .0107).
Using prostheses with a smaller neck-shaft angle and increased COR offset can significantly reduce scapular notching in RTSA at 1 year, possibly improving prosthesis survival.
肩胛骨切迹是反式全肩关节置换术（RTSA）的一种公认并发症。本文分析了假体设计对 RTSA 中肩胛骨切迹的影响。
从高级作者进行的所有 RTSA 的数据库中，纳入具有至少 12 个月随访的肩部（65 个肩部）。比较假体颈干角为 155°且无旋转中心（COR）偏移的肩部（1 组）与颈干角为 143°且 COR 偏移 2.5mm 的肩部（2 组）的切迹情况。P 值小于 0.05 被认为具有统计学意义。
即使在统计学上调整随访时间的差异后，1 组的切迹分级仍明显高于 2 组（P=0.0081）。1 组的切迹发生率为 60.7%，明显高于 2 组的 16.2%（P=0.0107）。
在 RTSA 中使用颈干角较小且 COR 偏移增加的假体可显著降低 1 年时的肩胛骨切迹，可能提高假体的存活率。
