Harmer Luke, Throckmorton Thomas, Sperling John W
Quincy Medical Group, 1118 Hampshire St, Quincy, IL, 62301, USA.
University of Tennessee-Campbell Clinic, 1211 Union Ave. Ste. 510, Memphis, TN, 38104, USA.
Curr Rev Musculoskelet Med. 2016 Mar;9(1):17-22. doi: 10.1007/s12178-016-9313-3.
Each generation of total shoulder arthroplasy has improved on the previous. The newest humeral component innovation is shortening the humeral component or eliminating the stem entirely to rely on stemless fixation in the humeral metaphysis. This offers theoretical advantages of preserved bone stock, less stress shielding, eliminating the diaphyseal stress riser, ease of stem removal at revision, and humeral head placement independent from the humeral shaft axis. There are a number of short term cohorts that have shown low complication rates and outcomes similar to previous generations of stemmed humeral components. Longer term and better designed studies are needed in order for short stems and stemless components to become the standard of care.
每一代全肩关节置换术都在前一代的基础上有所改进。最新的肱骨组件创新是缩短肱骨组件或完全去除柄部，依靠无柄固定在肱骨干骺端。这具有保留骨量、减少应力遮挡、消除骨干应力集中、翻修时便于取出柄部以及肱骨头位置独立于肱骨干轴线等理论优势。有一些短期队列研究表明，其并发症发生率较低，结果与前几代带柄肱骨组件相似。为了使短柄和无柄组件成为标准治疗方案，还需要进行更长期、设计更完善的研究。
