Musculoskeletal Science Research Group, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
J Shoulder Elbow Surg. 2013 Oct;22(10):1352-8. doi: 10.1016/j.jse.2013.01.027. Epub 2013 Apr 4.
Published data on the outcome of Copeland shoulder resurfacing arthroplasty (CSRA) are limited. This observational case series study reports the functional and radiological outcome of CSRA during a mean follow-up of 4 years and highlights the correlation between key outcome measures.
One-hundred two consecutive patients with osteoarthritis (OA-47.1%), rheumatoid arthritis (RA-40.2%), rotator cuff arthropathy (RCA-8.8%), and avascular necrosis (AVN-3.9%) underwent CSRA. The outcome assessment included pain and satisfaction, physical limitation, Oxford Shoulder score (OSS), Constant score (CS), and SF-12. Imaging was reviewed for glenoid morphology (Walch classification) and humeral head (HH) migration.
Highest patient satisfaction and lowest pain levels were related to the primary pathology with AVN best followed by OA, RA, and with RCA having the poorest outcome. Comparing the two largest groups the CS was significantly higher in OA (61 ± 21.3) than RA (44 ± 20.5). OSS showed a significant correlation with CS and physical subscale of SF-12. Walch type A (67.6%) and HH migration (47%) were the commonest radiographic observations. OSS, CS, pain, and satisfaction were significantly different between migration and nonmigration groups.
The CSRA resulted in satisfactory outcome in many patients. AVN and OA were associated with the best and RCA with the poorest results. The CSRA was associated with glenoid erosion and HH migration particularly in RCA. CSRA remains an option in the treatment of arthritic conditions of the shoulder but its future use may be limited to younger patients where implanting a glenoid may be regarded as problematic.
Copeland 肩关节表面置换术（CSRA）的结果已有相关文献报道，但数量有限。本观察性病例系列研究报告了 CSRA 的功能和影像学结果，平均随访时间为 4 年，并强调了关键结果测量之间的相关性。
102 例连续的骨关节炎（OA-47.1%）、类风湿关节炎（RA-40.2%）、肩袖关节炎（RCA-8.8%）和股骨头坏死（AVN-3.9%）患者接受了 CSRA。评估结果包括疼痛和满意度、身体限制、牛津肩评分（OSS）、Constant 评分（CS）和 SF-12。影像学评估包括肩盂形态（Walch 分类）和肱骨头（HH）迁移。
最高的患者满意度和最低的疼痛水平与原发性疾病相关，AVN 最好，其次是 OA，RA 最差，而 RCA 则最差。比较两个最大的组，OA 的 CS 明显高于 RA（61±21.3 比 44±20.5）。OSS 与 CS 和 SF-12 身体子量表显著相关。最常见的影像学观察结果为 Walch 型 A（67.6%）和 HH 迁移（47%）。OSS、CS、疼痛和满意度在迁移和非迁移组之间存在显著差异。
CSRA 为许多患者带来了满意的结果。AVN 和 OA 与最佳结果相关，而 RCA 则与最差结果相关。CSRA 与肩盂侵蚀和 HH 迁移有关，特别是在 RCA 中。CSRA 仍然是治疗肩部关节炎的一种选择，但由于植入肩盂可能被认为存在问题，其未来的使用可能会受到限制，仅限于年轻患者。
