Kadum Bakir, Hassany Hamid, Wadsten Mats, Sayed-Noor Arkan, Sjödén Göran
Department of Surgical and Perioperative Sciences (Orthopaedics-Sundsvall), Umeå University, Umeå, Sweden.
Orthopaedic department, Derby Hospital, Derby, UK.
Int Orthop. 2016 Apr;40(4):751-8. doi: 10.1007/s00264-015-2935-z. Epub 2015 Aug 11.
The aim of this study was to investigate the ability of a stemless shoulder prosthesis to restore shoulder anatomy in relation to premorbid anatomy.
This prospective study was performed between May 2007 and December 2013. The inclusion criteria were patients with primary osteoarthritis (OA) who had undergone stemless total anatomic shoulder arthroplasty. Radiographic measurements were done on anteroposterior X-ray views of the glenohumeral joint.
Sixty-nine patients (70 shoulders) were included in the study. The mean difference between premorbid centre of rotation (COR) and post-operative COR was 1 ± 2 mm (range -3 to 5.8 mm). The mean difference between premorbid humeral head height (HH) and post-operative HH was -1 ± 3 mm (range -9.7 to 8.5 mm). The mean difference between premorbid neck-shaft angle (NSA) and post-operative NSA was -3 ± 12° (range -26 to 20°).
Stemless implants could be of help to reconstruct the shoulder anatomy. This study shows that there are some challenges to be addressed when attempting to ensure optimal implant positioning. The critical step is to determine the correct level of bone cut to avoid varus or valgus humeral head inclination and ensure correct head size.
本研究旨在调查无柄肩关节假体相对于病前解剖结构恢复肩部解剖结构的能力。
本前瞻性研究于2007年5月至2013年12月进行。纳入标准为接受无柄全解剖型肩关节置换术的原发性骨关节炎（OA）患者。在肱骨头关节的前后位X线片上进行影像学测量。
69例患者（70个肩部）纳入研究。病前旋转中心（COR）与术后COR的平均差异为1±2mm（范围-3至5.8mm）。病前肱骨头高度（HH）与术后HH的平均差异为-1±3mm（范围-9.7至8.5mm）。病前颈干角（NSA）与术后NSA的平均差异为-3±12°（范围-26至20°）。
无柄植入物有助于重建肩部解剖结构。本研究表明，在试图确保最佳植入物定位时存在一些需要解决的挑战。关键步骤是确定正确的截骨水平，以避免肱骨头内翻或外翻倾斜并确保正确的头部尺寸。
