Cofield R H, Daly P J
Rochester, Minn., USA.
J Shoulder Elbow Surg. 1992 Mar;1(2):77-85. doi: 10.1016/S1058-2746(09)80124-9. Epub 2009 Feb 19.
A newly designed, uncemented, tissue-ingrowth glenoid component with a porous surface was used in association with the Neer humeral head prosthesis for 32 total shoulder arthroplasties in 29 patients. The diagnoses for the shoulders were osteoarthritis in 17, rheumatoid arthritis in eight, and traumatic arthritis in seven. Follow-up evaluations averaged 51 months (range, 29 to 80 months). Five complications occurred, necessitating four reoperations: two for glenoid component dissociation, one for humeral loosening, and one for infection. Little or no pain was experienced after the operation in 27 (96%) of the 28 shoulders that required no additional surgery. Average active abduction was 145°, average external rotation was 59°, and median internal rotation was to 112. Three glenoid components had probable loosening on radiographic examination. Eight shoulders had some degree of instability; a complication related to the glenoid component (polyethylene dissociation) or probable loosening not yet requiring reoperation developed in four of these (p < 0.02). These data support the continuing use of an uncemented, tissue-ingrowth glenoid component in arthritic shoulders with adequate bone support. Joint instability must be avoided to lessen complications and the need for revision surgery.
一种新设计的、非骨水泥型、具有多孔表面的组织长入式肩胛盂假体与Neer肱骨头假体联合用于29例患者的32例全肩关节置换术。这些肩关节的诊断情况为：骨关节炎17例，类风湿性关节炎8例，创伤性关节炎7例。随访评估平均为51个月（范围29至80个月）。发生了5例并发症，需要进行4次再次手术：2例因肩胛盂假体分离，1例因肱骨松动，1例因感染。在28例无需额外手术的肩部中，27例（96%）术后疼痛轻微或无疼痛。平均主动外展为145°，平均外旋为59°，内旋中位数为112°。X线检查显示3个肩胛盂假体可能松动。8个肩部有一定程度的不稳定；其中4个出现了与肩胛盂假体相关的并发症（聚乙烯分离）或可能松动但尚未需要再次手术（p<0.02）。这些数据支持在有足够骨支撑的关节炎性肩部继续使用非骨水泥型、组织长入式肩胛盂假体。必须避免关节不稳定以减少并发症和翻修手术的必要性。
