Natera L, Bruguera J, Atoun E, Levy O
Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España; Hospital General de Catalunya, Sant Cugat del Vallés, Barcelona, España.
Unidad de Hombro y Extremidad Superior, COT, Hospital San Juan de Dios, Pamplona, Navarra, España; Reading Shoulder Unit, Orthopaedics Department, Berkshire Independent Hospital, Reading, Berkshire, Reino Unido.
Rev Esp Cir Ortop Traumatol. 2016 May-Jun;60(3):175-83. doi: 10.1016/j.recot.2016.01.001. Epub 2016 Mar 2.
To assess the surgical parameters and the clinical and radiological outcomes of revisions of resurfacing shoulder arthroplasty to non-cemented short-stem reverse total shoulder arthroplasty.
A total of 23 revisions from resurfacing shoulder arthroplasty to reverse total shoulder arthroplasty were performed. The mean age was 70.3±11.95 years. The patients included 82.6% (19/23) revised for cuff failure; 13.04% (3/23) cuff failure and aseptic loosening, and 4.35% (1/23) peri-prosthetic fracture. The need for humeral osteotomy or structural allograft, operation length, blood loss, blood transfusions and intraoperative fractures were recorded. Minimum follow-up 25 months.
No humeral osteotomy or humeral structural allograft was required, and 2/23 (8.69%) required allograft for glenoid reconstruction. The mean operation time was 113.35±21.30minutes. Intra-operative blood loss was 374±245.09 mls. Blood transfusion was required in one case. Intra-operative fracture occurred in 1 case. The Constant score improved from 17.32 to 59.78 (age/sex adjusted, 84). Overall satisfaction improved from 1.37 to 8.04. The range of motion increased 79.57° in forward elevation; 72.88° in abduction; 38.06° in internal rotation; and 13.57° in external rotation. There was no evidence of radiolucency, subsidence, or bone resorption.
Revisions of resurfacing implants to non-cemented short-stem reverse prosthesis show good clinical and radiological outcomes, with minimal intra-operative complexities.
IV, case series.
评估表面置换型肩关节成形术翻修为非骨水泥短柄反式全肩关节成形术的手术参数以及临床和影像学结果。
共进行了23例从表面置换型肩关节成形术翻修为反式全肩关节成形术的手术。平均年龄为70.3±11.95岁。患者中因肩袖功能不全而翻修的占82.6%（19/23）；因肩袖功能不全和无菌性松动而翻修的占13.04%（3/23），因假体周围骨折而翻修的占4.35%（1/23）。记录肱骨截骨或结构性同种异体骨移植的需求、手术时间、失血量、输血情况及术中骨折情况。最短随访时间为25个月。
无需进行肱骨截骨或肱骨结构性同种异体骨移植，2/23（8.69%）需要同种异体骨进行肩胛盂重建。平均手术时间为113.35±21.30分钟。术中失血量为374±245.09毫升。1例需要输血。1例发生术中骨折。Constant评分从17.32提高到59.78（年龄/性别校正后为84）。总体满意度从1.37提高到8.04。前屈上举活动度增加79.57°；外展增加72.88°；内旋增加38.06°；外旋增加13.57°。没有透亮线、下沉或骨吸收的证据。
表面置换型植入物翻修为非骨水泥短柄反式假体显示出良好的临床和影像学结果，术中并发症最少。
IV，病例系列。
