全肩关节置换术：肱骨头假体是否在变短？
Total shoulder arthroplasty: are the humeral components getting shorter?
作者信息
Harmer Luke, Throckmorton Thomas, Sperling John W
机构信息
Quincy Medical Group, 1118 Hampshire St, Quincy, IL, 62301, USA.
University of Tennessee-Campbell Clinic, 1211 Union Ave. Ste. 510, Memphis, TN, 38104, USA.
出版信息
Curr Rev Musculoskelet Med. 2016 Mar;9(1):17-22. doi: 10.1007/s12178-016-9313-3.
Abstract
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.
摘要
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。
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本文引用的文献
1
Short stem shoulder replacement.短柄肩关节置换术。
Int J Shoulder Surg. 2014 Jul;8(3):72-5. doi: 10.4103/0973-6042.140113.
2
Stemless shoulder arthroplasty: current status.无柄肩关节置换术：现状
J Shoulder Elbow Surg. 2014 Sep;23(9):1409-14. doi: 10.1016/j.jse.2014.05.005. Epub 2014 Jul 11.
3
Humeral windows and longitudinal splits for component removal in revision shoulder arthroplasty.肱骨开窗和纵向劈开用于翻修肩关节置换术中的组件取出。
J Shoulder Elbow Surg. 2014 Oct;23(10):1485-91. doi: 10.1016/j.jse.2014.02.004. Epub 2014 Apr 22.
4
Long-stemmed humeral components in primary shoulder arthroplasty.肱骨柄长段在初次肩关节置换术中的应用。
J Shoulder Elbow Surg. 2014 Oct;23(10):1492-8. doi: 10.1016/j.jse.2014.01.008. Epub 2014 Apr 13.
5
Reverse shoulder arthroplasty with a short metaphyseal humeral stem.反式肩关节置换术，采用短干骺端肱骨柄。
Int Orthop. 2014 Jun;38(6):1213-8. doi: 10.1007/s00264-014-2328-8. Epub 2014 Apr 6.
6
Radiographic changes around humeral components in shoulder arthroplasty.肩关节置换术后肱骨头组件周围的影像学改变。
J Bone Joint Surg Am. 2014 Apr 2;96(7):e54. doi: 10.2106/JBJS.M.00378.
7
Short-stem uncemented primary reverse shoulder arthroplasty: clinical and radiological outcomes.短柄非骨水泥型初次反式肩关节置换术：临床与影像学结果。
Bone Joint J. 2014 Apr;96-B(4):526-9. doi: 10.1302/0301-620X.96B3.32702.
8
[Options and limits of stemless shoulder prostheses].
Orthopade. 2013 Jul;42(7):495-500. doi: 10.1007/s00132-012-2020-x.
9
Results of a stemless reverse shoulder prosthesis at more than 58 months mean without loosening.无柄反肩关节假体 58 个月以上的平均结果为未松动。
J Shoulder Elbow Surg. 2013 Sep;22(9):e1-6. doi: 10.1016/j.jse.2012.12.005. Epub 2013 Feb 15.
10
Stemless shoulder prosthesis versus conventional anatomic shoulder prosthesis in patients with osteoarthritis: a comparison of the functional outcome after a minimum of two years follow-up.骨水泥型非骨水泥型人工肱骨头置换治疗老年肱骨近端四部分骨折的临床研究
J Orthop Traumatol. 2013 Mar;14(1):31-7. doi: 10.1007/s10195-012-0216-9. Epub 2012 Nov 9.
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