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双相新鲜骨软骨同种异体移植治疗肩盂肱关节创伤后关节炎。

Bipolar fresh osteochondral allograft for the treatment of glenohumeral post-traumatic arthritis.

机构信息

Clinical Orthopaedic and Traumatology Unit II, Rizzoli Orthopaedic Institute, Bologna, Italy.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2012 Oct;20(10):1953-7. doi: 10.1007/s00167-011-1793-5. Epub 2011 Nov 24.

Abstract

PURPOSE

Surgical management of end-stage glenohumeral osteoarthritis represents a challenge in young patients. Bipolar fresh osteochondral allograft (BFOA) represents a fascinating option to prosthetic substitution. Aim of this report is to describe an original technique for BFOA implantation in the shoulder and to describe the clinical and histological results at 30-month follow-up.

METHODS

A 47-year-old man received BFOA of the shoulder. Clinical and radiographical evaluations were carried out periodically up to 30 months.

RESULTS

The clinical score increased from 40 to 78 points (Constant Score), decreased from 64 points to 10 (DASH Disability/Symptom Score) and from 94 points to 0 (DASH Work module Score). Radiographically arthritis and partial reabsorption of the implanted surfaces were evident.

CONCLUSIONS

The clinical result obtained in this patient seems to support the applicability of BFOA in the shoulder with severe post-traumatic arthritis and with intact rotator cuff. Although unrelated to the clinical result, the occurrence of arthritis of the implanted surfaces is cause of concern.

LEVEL OF EVIDENCE

Case report, Level V.

摘要

目的

对于年轻患者的终末期肩关节炎,手术治疗极具挑战性。双极新鲜骨软骨同种异体移植(BFOA)是一种替代假体的有趣选择。本报告旨在描述一种在肩部植入 BFOA 的原始技术,并描述 30 个月随访时的临床和组织学结果。

方法

一名 47 岁男性接受了肩部 BFOA。定期进行临床和影像学评估,最长达 30 个月。

结果

临床评分从 40 分增加到 78 分(Constant 评分),从 64 分下降到 10 分(DASH 残疾/症状评分),从 94 分下降到 0 分(DASH 工作模块评分)。影像学上可见关节炎和植入表面的部分吸收。

结论

该患者获得的临床结果似乎支持在严重创伤后关节炎和完整肩袖的肩部应用 BFOA。尽管与临床结果无关,但植入表面关节炎的发生令人担忧。

证据等级

病例报告,V 级。

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