Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
J Shoulder Elbow Surg. 2014 Feb;23(2):214-20. doi: 10.1016/j.jse.2013.05.012. Epub 2013 Aug 9.
Glenoid component fixation is an issue in shoulder arthroplasty for glenoid dysplasia with osteoarthritis because of the small amount of bone available. In 2002, we described 6 patients (7 shoulders) undergoing shoulder arthroplasty for this condition. This report expands that experience to further understand the role of anatomic shoulder arthroplasty (both hemiarthroplasty and total shoulder arthroplasty), to outline results, and to identify complications and reoperations-all to better understand whether other treatment options need to be developed and explored. Our hypothesis is that treatment of this problem with anatomic arthroplasty is not ideal.
Between 1980 and 2008, 20 patients (22 shoulders) underwent anatomic shoulder arthroplasty for treatment of osteoarthritis secondary to glenoid dysplasia. There were 8 hemiarthroplasties and 14 total shoulder arthroplasties. Average follow-up was 6 years (range, 0.4 to 23.1 years).
Pain was relieved in 4 of 8 shoulders undergoing hemiarthroplasty and in 10 of 14 shoulders undergoing total arthroplasty. Mean active elevation improved from 96° to 125°, and external rotation improved from 19° to 42°. Motion improvements were similar for hemiarthroplasty and total shoulder arthroplasty. Four shoulders having hemiarthroplasty underwent revision surgery because of painful glenoid arthrosis. Two shoulders with total arthroplasty underwent revision for infection, and 3 underwent revision for glenoid component issues.
Favorable results can be obtained with the use of anatomic implants in the treatment of glenoid dysplasia. However, continuing subluxation, glenoid arthrosis, and glenoid component problems necessitating revision surgery are frequent. Alternative treatment methods should be considered.
对于伴骨关节炎的肩胛盂发育不良的肩关节置换术，肩胛盂骨量不足是一个问题。2002 年，我们描述了 6 例（7 肩）此类患者行肩关节置换术的经验。本报告扩展了这一经验，以进一步了解解剖型肩关节置换术（半肩置换和全肩关节置换）的作用、总结结果、并确定并发症和再手术，以更好地了解是否需要开发和探索其他治疗方案。我们的假设是，解剖型关节置换术治疗该问题并不理想。
1980 年至 2008 年，20 例（22 肩）患者因肩胛盂发育不良继发骨关节炎接受解剖型肩关节置换术治疗。其中 8 例为半肩置换，14 例为全肩关节置换。平均随访 6 年（0.4-23.1 年）。
8 例半肩置换中 4 例、14 例全肩关节置换中 10 例疼痛缓解。主动活动度由 96°提高至 125°，外旋由 19°提高至 42°。半肩置换和全肩关节置换的运动改善相似。4 例半肩置换因肩胛盂关节炎疼痛行翻修手术，2 例全肩关节置换因感染行翻修手术，3 例因肩胛盂假体问题行翻修手术。
使用解剖型假体治疗肩胛盂发育不良可获得良好的结果，但仍常出现半脱位、肩胛盂关节炎和肩胛盂假体问题，需要行翻修手术。应考虑其他治疗方法。
