Davis Daniel E, Acevedo Daniel, Williams Alexis, Williams Gerald
Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Kaiser Permanente Medical Center, Panorama City, CA, USA.
J Shoulder Elbow Surg. 2016 Aug;25(8):1354-61. doi: 10.1016/j.jse.2015.12.010. Epub 2016 Feb 19.
Glenoid bone loss and severe retroversion can pose difficulties when implanting a glenoid component for total shoulder arthroplasty for primary osteoarthritis. Mini-glenoid implants may be useful in the setting of severe glenoid wear in which a standard pegged glenoid component cannot be placed.
This study is a retrospective review, performed over a 3-year period, of patients who received a total shoulder arthroplasty using an inset mini-glenoid in the setting of severe glenoid dysplasia and/or medial glenoid bone loss. We identified patients with a minimum of 2 years' follow-up and evaluated preoperative and postoperative range of motion, visual analog scale scores, Single Assessment Numeric Evaluation scores, complications, and patient satisfaction.
Seven patients (4 female and 3 male patients; 9 shoulders) with a mean age of 66 years were treated with the described procedure and had a mean follow-up of 34 months. There were 6 primary arthroplasties and 3 revision cases. Four shoulders were classified as Walch type A2 glenoids, 2 were classified as Walch type C, and 3 were unable to be classified. There was a statistically significant increase in range of motion (forward elevation, 48°; external rotation, 14°), decrease in pain scores (8 points to 1 point), and improvement in Single Assessment Numeric Evaluation scores (31.7% to 89.4%). The mean patient satisfaction score was 8.6 points on a 10-point scale.
At 2-year follow-up, total shoulder arthroplasty with a mini-glenoid component can offer adequate pain relief and functional results in the setting of glenoid bone loss or severe retroversion.
对于原发性骨关节炎行全肩关节置换术时，肩胛盂骨质丢失和严重后倾会给肩胛盂假体植入带来困难。在肩胛盂严重磨损而无法植入标准带栓肩胛盂假体的情况下，小型肩胛盂假体可能会有用。
本研究是一项回顾性研究，对在严重肩胛盂发育不良和/或肩胛盂内侧骨质丢失情况下使用内嵌式小型肩胛盂进行全肩关节置换术的患者进行了为期3年的随访。我们确定了至少随访2年的患者，并评估了术前和术后的活动范围、视觉模拟评分、单项评估数字评价评分、并发症及患者满意度。
7例患者（4例女性和3例男性；9个肩关节）平均年龄66岁，接受了上述手术，平均随访34个月。其中有6例初次置换和3例翻修病例。4个肩关节被归类为Walch A2型肩胛盂，2个为Walch C型，3个无法分类。活动范围有统计学意义的增加（前屈抬高48°；外旋14°），疼痛评分降低（从8分降至1分），单项评估数字评价评分改善（从31.7%提高到89.4%）。患者满意度平均得分为8.6分（满分10分）。
在2年的随访中，使用小型肩胛盂假体的全肩关节置换术在肩胛盂骨质丢失或严重后倾的情况下可提供充分的疼痛缓解和功能结果。
