Nuttall D, Birch A, Haines J F, Watts A C, Trail I A
Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, England, UK.
Bone Joint J. 2017 May;99-B(5):674-679. doi: 10.1302/0301-620X.99B5.BJJ-2016-0745.R1.
Radiostereometric analysis (RSA) allows an extremely accurate measurement of early micromotion of components following arthroplasty.
In this study, RSA was used to measure the migration of 11 partially cemented fluted pegged glenoid components in patients with osteoarthritis who underwent total shoulder arthroplasty using an improved surgical technique (seven men, four women, mean age 68). Patients were evaluated clinically using the American Shoulder and Elbow Surgeons (ASES) and Constant-Murley scores and by CT scans two years post-operatively.
There were two patterns of migration, the first showing little, if any, migration and the second showing rotation by > 6° as early as three months post-operatively. At two years, these two groups could be confirmed on CT scans, one with osseointegration around the central peg, and the second with cystic changes. Patients with osteolysis around the central peg were those with early migration and those with osseointegration had minimal early migration. Both groups,however,had similar clinical results.
Rapid early migration associated with focal lucency and absence of osseointegration was observed in three of 11 glenoid components, suggesting that lack of initial stability leads to early movement and failure of osseointegration. Cite this article: 2017;99-B:674-9.
放射性立体测量分析(RSA)能够极其精确地测量关节置换术后部件的早期微动情况。
在本研究中,RSA用于测量11例骨关节炎患者使用改良手术技术进行全肩关节置换术后部分骨水泥固定带槽柄状关节盂部件的移位情况(7名男性,4名女性,平均年龄68岁)。术后两年通过美国肩肘外科医师协会(ASES)和Constant-Murley评分对患者进行临床评估,并进行CT扫描。
存在两种移位模式,第一种模式显示几乎没有移位,第二种模式在术后三个月时就显示出超过6°的旋转。两年时,这两组在CT扫描上得到证实,一组在中心柄周围有骨整合,另一组有囊性改变。中心柄周围有骨溶解的患者是那些早期有移位的患者,而有骨整合的患者早期移位最小。然而,两组的临床结果相似。
在11个关节盂部件中有3个观察到与局部透亮和缺乏骨整合相关的快速早期移位,这表明初始稳定性不足会导致早期移动和骨整合失败。引用本文:2017;99-B:674-9。