Maier Michael W, Lauer Sarah, Klotz Matthias C, Bülhoff Matthias, Spranz David, Zeifang Felix
Clinic for Orthopedics and Trauma Surgery, Heidelberg University Hospital, Schlierbacher Landstraße 200a, D-69118, Heidelberg, Germany.
BMC Musculoskelet Disord. 2015 Oct 1;16:275. doi: 10.1186/s12891-015-0723-y.
Conventional stemmed anatomical shoulder prostheses are widely used in the treatment of glenohumeral osteoarthritis. The stemless shoulder prosthesis, in contrast, is a new concept, and fewer outcome studies are available. Therefore, the purpose of the study was to investigate the early functional outcome and postoperative proprioception of a stemless prosthesis in comparison with a standard stemmed anatomic shoulder prosthesis.
Twelve patients (mean age 68.3 years [SD ± 5.4]; 5 female, 7 male) with primary glenohumeral osteoarthritis of the shoulder were enrolled, who underwent total shoulder arthroplasty (TSA) with a stemless total shoulder prosthesis, Total Evolution Shoulder System (TESS; Biomed, France). The control group consisted of twelve (age and gender matched) patients (mean age 67.8 years; [SD ± 7.1]; 9 female, 3 male), getting a TSA with a standard anatomic stemmed prosthesis, Aequalis Shoulder (Tournier, Lyon, France). Patients were examined the day before and six months after surgery. The pre- and postoperative Constant Score (CS) was evaluated and proprioception was measured in a 3D video motion analysis study using an active angle-reproduction (AAR) test.
Comparing the postoperative CS, there was no significant difference between the groups treated with the TESS prosthesis (48.0 ± 13.8 points) and the Aequalis prosthesis (49.3 ± 8.6 points; p = 0.792). There was no significant difference in postoperative proprioception between the TESS group (7.2° [SD ± 2.8]) and the Aequalis group(8.7° [SD ± 2.7]; p = 0.196), either. Comparison of in the results of CS and AAR test pre- and postoperatively showed no significant differences between the groups.
In patients with glenohumeral osteoarthritis, treated with TSA, the functional and the proprioceptive outcome is comparable between a stemless and a standard stemmed anatomic shoulder prosthesis at early followup.
Further follow-up is necessary regarding the long-term performance of this prosthesis.
Current Controlled Trials DRKS 00007528 . Registered 17 November 2014.
传统带柄解剖型肩关节假体广泛应用于治疗盂肱关节骨关节炎。相比之下，无柄肩关节假体是一个新概念，相关的疗效研究较少。因此，本研究的目的是比较无柄假体与标准带柄解剖型肩关节假体的早期功能疗效和术后本体感觉。
纳入12例（平均年龄68.3岁[标准差±5.4]；5例女性，7例男性）原发性盂肱关节骨关节炎患者，他们接受了使用无柄全肩关节假体Total Evolution Shoulder System（TESS；法国Biomed公司）的全肩关节置换术（TSA）。对照组由12例（年龄和性别匹配）患者（平均年龄67.8岁；[标准差±7.1]；9例女性，3例男性）组成，他们接受了使用标准解剖型带柄假体Aequalis Shoulder（法国里昂Tournier公司）的TSA。在手术前一天和术后6个月对患者进行检查。评估术前和术后的Constant评分（CS），并在一项使用主动角度再现（AAR）测试的三维视频运动分析研究中测量本体感觉。
比较术后CS，使用TESS假体治疗的组（48.0±13.8分）与使用Aequalis假体治疗的组（49.3±8.6分；p = 0.792）之间无显著差异。TESS组（7.2°[标准差±2.8]）与Aequalis组（8.7°[标准差±2.7]；p = 0.196）术后本体感觉也无显著差异。术前和术后CS及AAR测试结果的组间比较也无显著差异。
在接受TSA治疗的盂肱关节骨关节炎患者中，在早期随访时，无柄和标准带柄解剖型肩关节假体的功能和本体感觉疗效相当。
关于该假体的长期性能，有必要进行进一步随访。
当前对照试验DRKS 00007528。于2014年11月17日注册。
