Division of Sports Medicine, Department of Orthopaedics, Naval Medical Center Portsmouth, Portsmouth, VA, USA.
J Shoulder Elbow Surg. 2013 Oct;22(10):1345-51. doi: 10.1016/j.jse.2013.04.015. Epub 2013 Jun 22.
Total shoulder arthroplasty as a treatment for glenohumeral degenerative joint disease is well accepted but has been less predictable with regard to outcomes and durability in a younger aged population, typically aged younger than 50 years. This younger population has a greater potential for glenoid component loosening. This has led surgeons to perform hemiarthroplasty or hemiarthroplasty with biological resurfacing of the glenoid in an effort to avoid the potential problems with a polyethylene glenoid and obtain durable and acceptable results for these patients.
The study included 44 patients, with 23 undergoing hemiarthroplasty alone and 21 undergoing hemiarthroplasty with biological resurfacing of the glenoid. All patients were aged younger than 50 years. Preoperative diagnoses, comorbidities, demographics, and range of motion were collected. Preoperative and postoperative radiographs were obtained. Preoperative and postoperative objective scoring measures (Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons score, visual analog scale, Simple Shoulder Test, Constant-Murley) were used.
Mean follow-up was 3.8 years for the hemiarthroplasty group and 3.6 years for the biological resurfacing group. Six patients in the hemiarthroplasty and 12 patients in the biological resurfacing group were considered failures due to revision surgery or an American Shoulder and Elbow Surgeons score <50. The hemiarthroplasty group had significantly better visual analog scale and Single Assessment Numeric Evaluation scores.
There was a significant failure rate in the hemiarthroplasty and the biologic resurfacing groups compared with results in the literature. Improved outcomes and lower failure rates were observed in the hemiarthroplasty group compared with the biological resurfacing group in this study.
全肩关节置换术作为治疗肩肱关节退行性关节病的方法已被广泛接受，但在年轻患者（通常年龄小于 50 岁）中，其疗效和耐用性更难预测。年轻患者的肩胛盂假体松动的可能性更大。这导致外科医生采用半肩置换术或半肩置换术联合生物型肩胛盂表面置换术，以避免聚乙烯肩胛盂可能出现的问题，并为这些患者获得持久和可接受的疗效。
本研究纳入了 44 例患者，其中 23 例行单纯半肩置换术，21 例行半肩置换术联合生物型肩胛盂表面置换术。所有患者的年龄均小于 50 岁。收集了术前诊断、合并症、人口统计学和活动范围等资料。获取了术前和术后的影像学资料。采用了术前和术后的客观评分指标（单一评估数字评估、美国肩肘外科医生评分、视觉模拟评分、简易肩功能测试、Constant-Murley 评分）。
半肩置换术组的平均随访时间为 3.8 年，生物型表面置换术组为 3.6 年。半肩置换术组中有 6 例和生物型表面置换术组中有 12 例患者因翻修手术或美国肩肘外科医生评分<50 而被认为是失败病例。半肩置换术组的视觉模拟评分和单一评估数字评估评分明显更好。
与文献报道的结果相比，半肩置换术和生物型表面置换术组的失败率均较高。与生物型表面置换术组相比，半肩置换术组的疗效更好，失败率更低。
