Fávaro Rodrigo Caldonazzo, Abdulahad Michel, Filho Salim Mussi, Valério Rafael, Superti Mauro José
Hospital Universitário Cajuru, Curitiba, PR, Brazil.
Rev Bras Ortop. 2015 Aug 20;50(5):523-9. doi: 10.1016/j.rboe.2015.08.005. eCollection 2015 Sep-Oct.
To evaluate the functional results from reverse arthroplasty and its complications and relationships with types of injury.
Twenty-seven shoulders (26 women and one man) were treated. The patients were assessed using the UCLA functional scale. The implant used was the Delta Xtend Depuy(®) model. The injuries were classified using the Seebauer method for the degree of arthroplasty and the Nerot method for notching.
The mean age was 77.4 years (range: 67-89) and the follow-up was 25.8 months (range: 6-51). The preoperative UCLA score was 10.1 (range: 6-15) and the postoperative UCLA score was 29.8 (range: 22-35), which was a statistically significant improvement (p < 0.001). According to the Seebauer classification, five patients were 1B, 19 were 2A and three were 2B. Fifteen cases presented complications (55.5%) and notching was the commonest of these, occurring in 14 patients (nine with grade 1 and five with grade 2), but this did not cause instability in any of them. Only one patient (3.7%) had a major complication, consisting of dislocation in the immediate postoperative period. Two patients (7.4%) said that they would undergo the procedure again. One patient (3.7%) underwent a revision procedure.
Reverse arthroplasty was shown to be an excellent option for treating patients with rotator cuff arthropathy, with a low rate of major complications. Notching was a frequent complication, but in the majority of the cases, it did not present clinical repercussions.
评估反式肩关节置换术的功能结果、并发症及其与损伤类型的关系。
对27例肩部患者（26例女性，1例男性）进行治疗。采用加州大学洛杉矶分校（UCLA）功能评分量表对患者进行评估。使用的植入物为Depuy公司的Delta Xtend型号。采用西伯尔（Seebauer）方法对关节置换程度进行损伤分类，采用内罗特（Nerot）方法对切迹进行分类。
平均年龄为77.4岁（范围：67 - 89岁），随访时间为25.8个月（范围：6 - 51个月）。术前UCLA评分为10.1分（范围：6 - 15分），术后UCLA评分为29.8分（范围：22 - 35分），差异具有统计学意义（p < 0.001）。根据西伯尔分类，5例为1B型，19例为2A型，3例为2B型。15例出现并发症（55.5%），其中切迹最为常见，14例患者出现切迹（9例为1级，5例为2级），但均未导致不稳定。只有1例患者（3.7%）出现严重并发症，为术后即刻脱位。2例患者（7.4%）表示愿意再次接受该手术。1例患者（3.7%）接受了翻修手术。
反式肩关节置换术是治疗肩袖关节病患者的极佳选择，严重并发症发生率低。切迹是常见并发症，但在大多数情况下，无临床影响。
