Donohue Kenneth W, Ricchetti Eric T, Iannotti Joseph P
Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, 9500 Euclid Ave., A40, Cleveland, OH, 44195, USA.
Curr Rev Musculoskelet Med. 2016 Mar;9(1):30-9. doi: 10.1007/s12178-016-9315-1.
Glenohumeral osteoarthritis produces a wide spectrum of glenoid pathology. The B2 glenoid is defined by asymmetric posterior bone loss with the development of a biconcavity and posterior translation of the humeral head. Progressive bone loss results in increasing glenoid retroversion, which must be corrected during anatomic shoulder arthroplasty. The goals of arthroplasty should also include centering the humeral head and restoring the normal glenoid joint line. When there is minimal bone loss, this may be accomplished with a standard glenoid component and asymmetric reaming. More significant bone loss requires bone grafting or the use of an augmented glenoid component. Reverse shoulder arthroplasty is also an option for older patients or patients with severe bone loss.
肩肱关节骨关节炎会产生多种关节盂病变。B2型关节盂的定义是后部骨质不对称性丢失，出现双凹畸形以及肱骨头向后移位。骨质的逐渐丢失会导致关节盂后倾增加，在解剖型肩关节置换术中必须对此进行矫正。关节置换术的目标还应包括使肱骨头居中并恢复正常的关节盂关节线。当骨质丢失较少时，使用标准的关节盂假体和不对称扩孔钻即可实现这一目标。骨质丢失更严重时，则需要进行骨移植或使用增强型关节盂假体。对于老年患者或骨质严重丢失的患者，反式肩关节置换术也是一种选择。
